Abdallah et al. 2015 / Abdelhamid et al. 2016 / Aliste et al. 2016 / Chun et al. 2016 / Dawson et al. 2016 / Desmet et al. 2013 / Kawanishi et al. 2014 / Leurcharusmee et al. 2016 / Munoz et al. 2016 / Naim et al. 2016 / Rahangdale et al. 2014 / Rosenfeld et al. 2016 / YaDeau et al. 2015 / Sakae et al. 2017
Dose of Dexamethasone / 8mg / 8mg / 8mg / 5mg / 8mg / 10mg / 4mg / 5mg / 8mg / 8mg / 8mg / 8mg / 4mg / 4mg
Duration of Analgesia / NS (P=1.0) / S, DPN (P<0.001) / S, DPN (p=0.02) / NS (p=0.27) / NS (p=0.6254) / S, DPN (p=0.008) / S, DPN (p=0.014) / S, DPN (p<0.00001) / S, DPN (p=0.002) / S, DPN (p=0.03) / NS (p=0.76) / NS (p=0.11)
Duration of Motor Blockade / S, DIV (P<0.00001) / S, DPN (P<0.01) / S, DPN (P<0.001) / NS (p=0.34) / S, DPN (p=0.009) / NS (p=0.34) / S, DPN (p=0.04) / S, DPN (p<0.05)
Post-operative Opioid Consumption / -24-hour opioid consumption reduced similarly in both DPN and DIV groups / -24 hours: S, DPN (p=0.03)
-24-48 hours: NS (p=0.34) / -0-1 days: NS (p=0.15)
-2-7 days: NS (p=0.17) / -0 patents in DPN group required opioids and three patients in DIV required opioids within 24 hours / -24 hours: S, DPN (p<0.0001)
-48 hours: S, DPN (p<0.0001) / -no rescue analgesics consumed in either group that received dexamethasone / -24 hours: NS (p=0.40)
-48 hours: NS (p=0.68)
-2 weeks: NS (p=0.67) / -24 hours: NS (p=0.10) / -24 hours: eight patients each in DPN and DIV group required opioids / -0/20 patients in DPN group versus 4/20 patients in DIV group required opioids (NS)
Post-operative Pain Scores / -8 hours: NS
-24 hours:NS
-1 week: NS
-2 weeks: NS / -30 min: NS (p=1.0)
-2 hours: NS (p=1.0)
-4 hours: NS (p=1.0)
-6 hours: NS (p=1.0)
-12 hours: NS (p=1.0)
-24 hours: NS (p=0.7) / -6 hours: NS (p=0.31)
-12 hours: NS (p=0.13)
-24 hours: (p=0.80)
-48 hours: NS (p=0.97) / -when block wore off: NS (p=0.13)
-7 days: NS (p=0.12) / -24 hours: NS (p=0.29)
-48 hours: S, DIV (p=0.007) / -morning after surgery: S, DPN (p=0.03) / -24 hours: S, DPN (p<0.00001)
-48 hours: S, DPN (p<0.0001) / -24 hours: rest, S, DPN (p=0.04); activity, NS (p=0.07)
-48 hours: rest, NS (p=0.23); activity, NS (p=0.68)
-2 weeks: rest, NS (p=0.94); activity, NS (p=0.92) / -4 hours: NS (p=1.0)
-8 hours: NS (p=0.39)
-12 hours: NS (p=0.11)
-16 hours: NS (p=0.42)
-20 hours: NS (p=0.28)
-48 hours: NS (p=0.86)
-1 week: NS (p=0.84) / -24 hours: rest, NS (p=0.098); activity, NS (p=0.390)
-48 hours: rest, NS (p=0.460); activity, NS (p=0.475) / -12 hours: NS
-24 hours: NS
Adverse Events / -one episode of nausea and vomiting in first 24 hours post-operatively in both DPN and DIV groups
-no block related complications / -12 patients excluded from analysis due to block failure (groups not listed)
-1 complication in DPN group; 1 complication in DIV group. Specific complication not reported. / -1-week follow-up revealed no motor deficits in either group
-one patient in DIV group had residual digital paresthesia that resolved by one month follow-up / -within 24 hours after surgery: nine patients in the DIV group and 11 patients in the DPN had motor block; events resolved by next day
-at 24 hour hours after surgery, one patient in DIV and two patients in DPN reported numbness; events resolved by next day
-one episode of diaphragm elevation in both DPN and DIV (p=1.0)
-6 episodes of nausea and vomiting in DIV and 3 episodes in DPN in first 48 hours post-operatively hours (p=0.31)
-two episodes of dizziness in DIV group and one episode in DPN in first 48 post-operatively hours (p=0.61)
-No significant difference in post-operative glucose values between two groups (p=0.49) / -no patient complained of nausea or vomiting in each group post-operatively / -at 24 hours: five patients in DPN group and three patients in DIV had motor block; events resolved by next day
-24 patients in DPN group and 20 patients in DIV had Horner’s Syndrome, NS
-12 patients each in DPN and DIV group had hoarseness, NS
-no neurological side effects noted at 2-6-month follow-up
- No significant difference in post-operative glucose values between two groups / -one patient in DIV group experienced nausea and vomiting
-one patient in DIV experienced nausea and vomiting
-at 4 weeks one patient complained of redness at site of DIV injection; this gradually disappeared with no treatment / -no sensory or motor deficits at 1 week follow-up / -no cases of paresthesia, numbness, or weakness at time of discharge
-no cases of injection site hematoma
-24-48 hours: three patients in DIV and one patient in DPN had of nausea and vomiting, three patients in DIV had hyperglycemia, and one patient in DIV developed infection / -no adverse events reported / -24 hours: seven patients DPN group and six patients in DIV group reported paresthesia; 11 patients in DPN group and seven patients in DIV group reported numbness; one patient in DIV group reported muscle weakness
-48 hours: six patients in DPN group and two patients in DIV group reported paresthesia; one patient in DPN group reported dysethesia; seven patients in DPN group and five in DIV group reported numbness
-2 weeks: two patients in DPN group reported paresthesia; one patient in DIV group reported dysesthesia; two patients each in DPN and DIV reported numbness
-1 month: one patient in DPN and two patients in DIV reported numbness
-2 months: no neurological symptoms reported / -24 hours: three patient experienced nausea in DPN group and two patients experienced nausea in DIV group; one patient experienced hoarseness in DPN group / -24 hours: five patients in DPN group and six patients in DIV group experienced nausea
-30 days: one patient in DIV group reported decreased sensation at surgical scar (not attributed to nerve blockade) and one patient in DPN group reported foot in numbness which resolved by 6 months
Other Key Results / -patients in DPN and DIV reported higher satisfaction with pain relief in comparison to control / -sensory block duration not significantly different (p=0.24) / -sensory block duration significantly favored DPN (p<0.001) / -patients in the DPN group reported significantly higher satisfaction with pain relief in comparison to DIV (p=0.02) / -patient satisfaction, NS / -sensory block duration significantly favored DPN (p=0.002) / -patient satisfaction, S, DPN (p<0.025) / -no significant difference between DIV and DPN groups in regards to Quality of Recovery score
-no significant difference in patient satisfaction for pain relief (p=0.14) / -no significant difference in patient satisfaction at 24 hours, 48 hours and one week between DPN and DIV (p >0.05) / -duration of sensory block significantly higher in DIV group than DPN group (p<0.05)
NS=not significant; S=significant; DPN= perineural dexamethasone, DIV = intravenous dexamethasone
For duration outcomes, a significant benefit favoring one group means that there was a gain in time for the specific outcome. For opioid consumption, pain score, and adverse event data, a significant benefit favoring one group means that there was a decrease in the of outcome for the specific group. Some data may differ from that reported in the original published study due to additional information provided from the corresponding author.