{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:42:49Z","timestamp":1792190569057,"version":"4.4.0"},"reference-count":15,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T00:00:00Z","timestamp":1726012800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Despite increasingly wider use, there remains controversy among anesthesiologists regarding preferred formulations and the role of steroid adjuvants in regional anesthesia. There is also uncertainty in the role of dexamethasone when administered directly versus peripherally. We hypothesize that directly mixing dexamethasone into the regional nerve block rather than peripherally administered intravenous dexamethasone will demonstrate a difference in efficacy concerning duration and rebound pain, decreased postoperative pain scores, or opioid consumption within the short-term postoperative period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A prospective, randomized controlled blinded study was conducted for patients undergoing open reduction and internal fixation with a volar plate technique for distal radius fractures. Patients were randomized for their preoperative anesthesia. One group had ultrasound-guided supraclavicular block with ropivacaine with a direct mix of dexamethasone 4 mg (Direct group), while the other group had ultrasound-guided supraclavicular block with ropivacaine and peripheral intravenous dexamethasone 4 mg (Indirect group). Data was collected pre, intra, and postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Fifty patients consented and participated in the study, with 27 participants in the direct group and 23 participants in the indirect group. Compared to intravenous administration, directly administered dexamethasone demonstrated a significant difference in the average time for the block to fade, onset of motor and sensory recovery, and block resolution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our findings prove that directly mixing dexamethasone compared to peripherally administered intravenous dexamethasone will demonstrate a difference in efficacy with regards to duration and rebound pain, but do not prove that there will be a difference in decreased postoperative pain scores or opioid consumption within the 24-hour postoperative period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Prognosis Level I<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15589447241270678","type":"journal-article","created":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T06:33:08Z","timestamp":1726122788000},"page":"1132-1137","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Efficacy of Direct Versus Peripheral Adjuvant Dexamethasone on Duration and Rebound Pain in Regional Anesthesia for Outpatient Distal Radius Fracture Fixation: A Prospective Randomized Controlled Blinded Study"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5304-6377","authenticated-orcid":false,"given":"Alexis A.","family":"Kasper","sequence":"first","affiliation":[{"name":"Rothman Orthopaedic Institute, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3698-7057","authenticated-orcid":false,"given":"Kyle","family":"Plusch","sequence":"additional","affiliation":[{"name":"Rothman Orthopaedic Institute, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armen","family":"Voskerijian","sequence":"additional","affiliation":[{"name":"Thomas Jefferson University, Philadelphia, PA, USA"},{"name":"Jefferson Surgery Center at the Navy Yard, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Barnabei","sequence":"additional","affiliation":[{"name":"Thomas Jefferson University, Philadelphia, PA, USA"},{"name":"Jefferson Surgery Center at the Navy Yard, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Rivlin","sequence":"additional","affiliation":[{"name":"Rothman Orthopaedic Institute, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro K.","family":"Beredjiklian","sequence":"additional","affiliation":[{"name":"Rothman Orthopaedic Institute, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark L.","family":"Wang","sequence":"additional","affiliation":[{"name":"Rothman Orthopaedic Institute, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,9,11]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-021-01499-z"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/15589447211008558"},{"issue":"1","key":"e_1_3_2_4_2","first-page":"1","article-title":"Perineural dexamethasone added to local anesthesia for brachial plexus block improves pain but delays block onset and motor blockade recovery","volume":"18","author":"Knezevic NN","year":"2015","unstructured":"Knezevic NN, Anantamongkol U, Candido KD. Perineural dexamethasone added to local anesthesia for brachial plexus block improves pain but delays block onset and motor blockade recovery. Pain Physician. 2015;18(1):1-14.","journal-title":"Pain Physician"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2019.10.74"},{"key":"e_1_3_2_6_2","first-page":"179029","article-title":"Perineural dexamethasone to improve postoperative analgesia with peripheral nerve blocks: a meta-analysis of randomized controlled trials","volume":"2014","author":"De Oliveira GS","year":"2014","unstructured":"De Oliveira GSJr, Castro Alves LJ, Nader A, et al Perineural dexamethasone to improve postoperative analgesia with peripheral nerve blocks: a meta-analysis of randomized controlled trials. Pain Res Treat. 2014;2014:179029.","journal-title":"Pain Res Treat"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000000248"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000254"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.2344\/anpr-67-03-14"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3109\/03009734.2013.768315"},{"issue":"11","key":"e_1_3_2_11_2","first-page":"638","article-title":"Comparison of ondansetron, dexamethasone, ondansetron plus dexamethasone and placebo in the prevention of nausea and vomiting after laparoscopic tubal ligation","volume":"101","author":"Biswas BN","year":"2003","unstructured":"Biswas BN, Rudra A, Mandal SK. Comparison of ondansetron, dexamethasone, ondansetron plus dexamethasone and placebo in the prevention of nausea and vomiting after laparoscopic tubal ligation. J Indian Med Assoc. 2003;101(11):638-642.","journal-title":"J Indian Med Assoc"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.37419"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/76.6.835"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000004557"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011770.pub2"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.4097\/kja.21390"}],"container-title":["HAND"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15589447241270678","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15589447241270678","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15589447241270678","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:29:38Z","timestamp":1777447778000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15589447241270678"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,11]]},"references-count":15,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1177\/15589447241270678"],"URL":"https:\/\/doi.org\/10.1177\/15589447241270678","relation":{},"ISSN":["1558-9447","1558-9455"],"issn-type":[{"value":"1558-9447","type":"print"},{"value":"1558-9455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,11]]}}}