Abstract
Background Both dexamethasone and dexmedetomidine are commonly used local anaesthetic adjuvants in brachial plexus block to enhance the blocking effect. However, it is unclear which of the two drugs is more effective in a brachial plexus block. This article compares the effects of dexamethasone and dexmedetomidine combined with local anaesthetics in brachial plexus block through meta-analysis, availing information for current practice and future research. Methods We conducted a search of the PubMed, Embase, Cochrane Library, and Web of Science databases to identify studies investigating the effects of dexamethasone and dexmedetomidine combined with local anaesthetics on brachial plexus block. The databases were searched from their inception to October 2021. Clinical randomized controlled trials were included. Two researchers independently conducted literature screening. The Cochrane System Review Manual was adopted for literature quality evaluation, whereas Stata 14.0 software aided in the meta-analysis. The duration of analgesia was the primary outcome indicator; whereas, the secondary outcome indicators included the duration of sensory block and motor block. Results Seven articles were analysed, including 465 patients. Compared to the dexmedetomidine group, the dexamethasone group exhibited longer durations of analgesia (WMD = 111.29, 95% CI: 16.49–206.10, P = 0.021), sensory block (WMD = 173.20, 95% CI: 86.69–259.71, P < 0.0001), and motor block (WMD = 121.03, 95% CI: 12.87–229.20, P = 0.028). Conclusion The present meta-analysis results affirm that dexamethasone is a better local anaesthetic adjuvant in brachial plexus block that enhances the blocking effect. Nevertheless, the existing heterogeneity warrants additional large-scale, multicentre, high-quality randomized controlled trials in the future for further verification and to provide more reliable clinical evidence.
Highlights
Compared to general anaesthesia, brachial plexus block has more merits, including low cost, fewer adverse reactions, less postoperative pain, and shorter hospital stay
Inclusion criteria included randomized controlled trials of brachial plexus block, adult patients aged 18 years and older, and a group of local anaesthetics combined with dexmedetomidine or local anaesthetics combined with intravenous dexmedetomidine and another group of local anaesthetics combined with perineuronal dexamethasone or local anaesthetics combined with intravenous dexamethasone
We applied Egger’s test and Begg’s test to evaluate publication bias. e duration of analgesia, sensory block, and motor block all had no publication bias (Begg’s P 0.624, Egger’s P 0.549; Begg’s P 0.881, Egger’s P 0.852; Begg’s P 0.573, Egger’s P 0.573) (Figures 9–11). This meta-analysis directly compared the effects of dexamethasone versus dexmedetomidine as an adjuvant for local anaesthetics on brachial plexus block
Summary
Both dexamethasone and dexmedetomidine are commonly used local anaesthetic adjuvants in brachial plexus block to enhance the blocking effect. It is unclear which of the two drugs is more effective in a brachial plexus block. Is article compares the effects of dexamethasone and dexmedetomidine combined with local anaesthetics in brachial plexus block through meta-analysis, availing information for current practice and future research. We conducted a search of the PubMed, Embase, Cochrane Library, and Web of Science databases to identify studies investigating the effects of dexamethasone and dexmedetomidine combined with local anaesthetics on brachial plexus block. E databases were searched from their inception to October 2021.
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