Analgesic Comparison of Perineural With Intravenous Dexamethasone on Interscalene Block for Shoulder Arthroscopy: a Meta-analysis of Randomized Controlled Trials

Abstract

Introduction: The analgesic comparison of perineural with intravenous dexamethasone on interscalene block for pain management of shoulder arthroscopy remains controversial. We conduct a systematic review and meta-analysis to explore the influence of perineural with intravenous dexamethasone on interscalene block on the postoperative pain intensity of shoulder arthroscopy.Methods: We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through April 2021 for randomized controlled trials (RCTs) assessing the effect of perineural with intravenous dexamethasone on interscalene block for pain control of shoulder arthroscopy. This meta-analysis is performed using the random-effect model.Results: Five RCTs are included in the meta-analysis. Overall, compared with intravenous dexamethasone for shoulder arthroscopy, perineural dexamethasone leads to similar block duration (SMD=0.12; 95% CI=-0.12 to 0.35; P=0.33), pain scores at 12 h (SMD=-0.67; 95% CI=-1.48 to 0.15; P=0.11), pain scores at 24 h (SMD=-0.33; 95% CI=-0.79 to 0.14; P=0.17), opioid consumption (SMD=0.01; 95% CI=-0.18 to 0.19; P=0.95) and nausea/vomiting (OR=0.74; 95% CI=0.38 to 1.44; P=0.38).Conclusions: Perineural and intravenous dexamethasone demonstrated comparable pain control after shoulder arthroscopy when supplemented to interscalene block.