The Dose Response and Effects of Dexamethasone on Bupivacaine Microcapsules for Intercostal Blockade (T9 to T11) in Healthy Volunteers

A systematic review and meta‐analysis of perineural dexamethasone for peripheral nerve blocks

“…Dexamethasone, a high-potency, long-acting glucocorticoid with little mineralocorticoid effect, has been shown to prolong peripheral nerve blockade in animals [5][6][7][8] and, when added to bupivacaine microspheres, to extend the duration of analgesia in humans [9,10]. Although incompletely understood, dexamethasone's mechanism of action may stem from decreased nociceptive C-fibre activity via a direct effect on glucocorticoid receptors [11] and inhibitory potassium channels [12].…”

Low-dose dexamethasone with levobupivacaine improves analgesia after supraclavicular brachial plexus blockade

“…For single-shot techniques, various adjuvants have been used to improve the quality and increase the duration of the local anaesthetic action in different peripheral nerves and regional blockade techniques. The analgesic effects of spinal and systemic corticosteroids in combination with local anaesthetics have been approved in human studies, whereas dexamethasone microspheres have increased blockade duration in both human and animal studies [6][7][8][9]. Furthermore, dexamethasone has been shown to possess an anti-inflamatory action [10].…”

A Prospective Observational Study of Ropivacaine and Ropivacaine with Dexamethasone, in Low Inter Scalene Brachial Plexus Blockade for Adult Upper Limb Orthopedic Surgeries in a Tertiary Care Centre

“…Many investigators have tried mixing local anaesthetic with various adjuvants like epinephrine, opioids, clonidine, ketamine, and midazolam, in an attempt to prolong analgesia from nerve blocks, but the results are either inconclusive or associated with side effects (5) . However the glucocorticoid (7) ; dexamethasone have found to be effective in some of the clinical studies (1), (2), (4), (5), (8), (10), (12).…”

“…Perineural injection of glucocorticoid along with local anaesthetics is reported to influence the onset and duration of sensory and motor block (5) (13) (14) . A more attractive theory suggests that dexamethasone increases the activity of inhibitory potassium channels on nociceptive C-fibres via glucocorticoid receptors, thus decreasing the activity of these neurons (7), (8) The current observational study was designed to test the hypothesis that dexamethasone as an adjuvant to local anaethetic ropivacaine in low interscalene brachial plexus block shorten the onset of sensory block, enhances the duration of analgesia, quality of block as compared with Ropivacaine alone.…”