title: [Glucocorticoids as an adjunct in peripheral regional anesthesia. Move to the "Holy Grail of perineural analgesia"?!].
abstract: BACKGROUND
  The role of dexamethasone as an adjunct in peripheral nerve blockades is still unclear.
  
  
  OBJECTIVE
  This article reviews the actual knowledge and scientific evidence for dexamethasone as an adjunct in peripheral regional anesthesia. Moreover, it discusses the benefits of the systemic versus the perineural mode of application.
  
  
  RESULTS
  Dexamethasone prolongs sensible as well as motor blockades in peripheral nerve blocks when applied intravenously or perineurally. Regarding potentially local neurotoxicity, published patient data are not sufficient for final conclusions.
  
  
  CONCLUSIONS
  After reviewing the actual literature, the authors prefer a systemic application mode (intravenously) over a perineural route of administration of dexamethasone as an adjunct for peripheral nerve blocks. This is due to the better understanding of potential side effects of the drug when applied intravenously. Dexamethasone might be a useful drug adjunct to prolong peripheral single shot nerve blocks.
authors.affiliation: Klinik für Anästhesie und Intensivtherapie, Universitätsklinik Gießen und Marburg, Baldingerstraße, 35033, Marburg, Deutschland. wiesmann@med.uni-marburg.de.
authors.forename: T
authors.initials: T
authors.lastname: Wiesmann
authors.affiliation: Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum des Saarlandes, Homburg, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Volk
authors.affiliation: Klinik für Anästhesie und Intensivtherapie, Universitätsklinik Gießen und Marburg, Baldingerstraße, 35033, Marburg, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Steinfeldt
mesh_terms: D000759:Adjuvants, Anesthesia / Q000009:adverse effects; D000698:Analgesia / Q000379:methods*; D000765:Anesthesia, Conduction / Q000379:methods*; D003907:Dexamethasone / Q000009:adverse effects; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D009407:Nerve Block
chemical_list: D000759:Adjuvants, Anesthesia; D005938:Glucocorticoids; D003907:Dexamethasone
keywords: Adjunct; Dexamethasone; Nerve blocks; Perineural application; Periphereal regional anesthesia