• Reg Anesth Pain Med · Nov 2014

    Adjuvant Dexamethasone: Innovation, Farce, or Folly?

    A cautionary summary of the benefits and potential risks of perineural dexamethasone.

    "...there have been no reports of neurotoxicity or complications of any kind attributed to perineural dexamethasone in the nearly 700 patients who have received it in published studies of peripheral nerve blocks ... We must acknowledge that complications in regional anesthesia are rare, and 700 patients are woefully inadequate to declare dexamethasone safe for routine perineural use." (Noss 2014)

    Noss concludes that:

    • Perineural dexamethasone is probably safe, though conclusive safety evidence is still lacking.
    • Systemic effects from IV dex is unlikely to explain the profound block prolongation.
    • Prolongation is not enough on its own.
    summary
    • Christopher D Noss, Lindsay D MacKenzie, and Mark A Kostash.
    • From the Department of Anesthesia, University of Calgary, Calgary, Alberta, Canada.
    • Reg Anesth Pain Med. 2014 Nov 1; 39 (6): 540-5.

    no abstract available

      Pubmed     Full text  

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    This article appears in the collection: Does dexamethasone safely prolong peripheral nerve blocks?.

    Notes

    summary
    1

    A cautionary summary of the benefits and potential risks of perineural dexamethasone.

    "...there have been no reports of neurotoxicity or complications of any kind attributed to perineural dexamethasone in the nearly 700 patients who have received it in published studies of peripheral nerve blocks ... We must acknowledge that complications in regional anesthesia are rare, and 700 patients are woefully inadequate to declare dexamethasone safe for routine perineural use." (Noss 2014)

    Noss concludes that:

    • Perineural dexamethasone is probably safe, though conclusive safety evidence is still lacking.
    • Systemic effects from IV dex is unlikely to explain the profound block prolongation.
    • Prolongation is not enough on its own.
    Daniel Jolley  Daniel Jolley
     
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