REVISTA

Dexametasona en anestesia regional: ¿viajar por un callejón sin salida?

Descripción: La edición actual de Anestesia contiene dos investigaciones en las que se usa dexametasona en combinación con anestesia regional. Antes de examinar la contribución de estos artículos, es necesario discutir varias preguntas relevantes para este tema

TITULO FUENTE ORIGINAL:

Dexamethasone in regional anaesthesia: travelling up a blind alley?

AUTORES:

P Marhofer, P M Hopkins

REVISTA ABREV.:

Anaesthesia

AÑO:

2019

REFERENCIA:

74(8):969-972

DOI:

10.1111/anae.14700

RESUMEN ORIGINAL:

The use of dexamethasone, administered either systemically or perineurally, as an adjunct to peripheral or neuraxial regional blocks, is currently one of the hottest topics in the field of regional anaesthesia. A large number of clinical studies have investigated this off‐label application of dexamethasone in recent years, with many reporting enhanced sensory block and/or improved... + Leer más

The use of dexamethasone, administered either systemically or perineurally, as an adjunct to peripheral or neuraxial regional blocks, is currently one of the hottest topics in the field of regional anaesthesia. A large number of clinical studies have investigated this off‐label application of dexamethasone in recent years, with many reporting enhanced sensory block and/or improved postoperative analgesia following either intravenous (i.v.) or perineural dexamethasone. The current edition of Anaesthesia contains two investigations where dexamethasone is used in combination with regional anaesthesia. Heesen et al. present a systematic review and meta‐analysis of the effect of the i.v. administration of dexamethasone on postoperative pain after spinal anaesthesia and Albrecht et al. report a randomised, controlled, triple‐blind study designed to assess whether there is a dose–response relationship for the effect of perineural dexamethasone added to local anaesthetic for interscalene brachial plexus block. Before examining the contribution of these papers to the body of knowledge, it is necessary to discuss several questions relevant to this topic: why has dexamethasone become the focus for clinical studies of regional anaesthesia despite a lack of mechanistic evidence to support an effect on block duration and nerve conduction? Why do most of these studies have positive outcomes? Why should we be cautious about the interpretation of meta‐analyses (not only in this field of science)?

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