{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T09:27:05Z","timestamp":1774430825674,"version":"3.50.1"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Paresthesias occurring during combined spinal-epidural labor analgesia due to needle puncture or epidural catheter placement may lead to nerve injury. We compared the effects of epidural dexamethasone versus methylprednisolone on neurological outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective, randomized, double-blind clinical trial conducted at a Chinese obstetrics hospital, parturients who developed paresthesias during combined spinal-epidural labor analgesia due to needle puncture or epidural catheter placement were randomized to receive an epidural injection of dexamethasone (5\u202fmg) or methylprednisolone (40\u202fmg). The primary outcome was neurological function at 14\u202fdays postpartum, including impaired skin sensation, decreased muscle strength, or other neurological symptoms. Secondary outcomes included adverse events and changes in inflammatory biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 315 parturients were randomized and completed the study. At 14\u202fdays postpartum, the neurological function outcomes did not differ significantly between the two groups (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;gt;\u202f0.05). Among the secondary outcomes, the dexamethasone group had a higher incidence of epidural-related maternal fever (ERMF) (7.6% vs. 2.5%,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.05), and the 24-h postpartum serum Interleukin-6 (IL-6) level was significantly higher than that in the methylprednisolone group [26.1 (18.2\u201338.9) pg.\/mL vs. 15.4 (13.2\u201317.6) pg.\/mL,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.05]. There were no significant differences between the two groups in postpartum hemorrhage, nausea and vomiting, instrumental delivery rate, Neonatal Intensive Care Unit (NICU) admission rate, or 24-h postpartum serum C-reactive protein (CRP) level (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;gt;\u202f0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In parturients who developed paresthesia during combined spinal-epidural labor analgesia, epidural administration of dexamethasone or methylprednisolone resulted in comparable neurological outcomes at 14\u202fdays postpartum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.chictr.org.cn\/<\/jats:ext-link>\n                      , identifier ChiCTR2300078866\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1785911","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T06:54:36Z","timestamp":1774421676000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative effectiveness of dexamethasone versus methylprednisolone for neuropathic outcomes after combined spinal-epidural labor analgesia: a prospective, randomized, double-blind trial"],"prefix":"10.3389","volume":"13","author":[{"given":"Bo","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Chengdu Jinjiang District Women & Children Health Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoyan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Chengdu Jinjiang District Women & Children Health Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huiru","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Chengdu Jinjiang District Women & Children Health Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Na","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Chengdu Jinjiang District Women & Children Health Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Chengdu Jinjiang District Women & Children Health Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siyan","family":"Dou","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Chengdu Jinjiang District Women & Children Health Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoqin","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Chengdu Jinjiang District Women & Children Health Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Na","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Chengdu Jinjiang District Women & Children Health Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fei","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Chengdu Jinjiang District Women & Children Health Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1016\/j.bpa.2019.07.007","article-title":"Complications and liability related to regional and neuraxial anesthesia","volume":"33","author":"Liu","year":"2019","journal-title":"Best Pract Res Clin Anaesthesiol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1093\/bja\/aen360","article-title":"Major complications of central neuraxial block: report on the third National Audit Project of the Royal College of Anaesthetists","volume":"102","author":"Cook","year":"2009","journal-title":"Br J Anaesth"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1016\/j.csm.2021.11.006","article-title":"Regional anesthesia complications and contraindications","volume":"41","author":"Shams","year":"2022","journal-title":"Clin Sports Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"4665","DOI":"10.3390\/ijms24054665","article-title":"Spinal cord injury and complications related to Neuraxial Anaesthesia procedures: a systematic review","volume":"24","author":"Pozza","year":"2023","journal-title":"Int J Mol Sci"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1016\/j.spinee.2013.06.041","article-title":"Comparison of toxicity effects of ropivacaine, bupivacaine, and lidocaine on rabbit intervertebral disc cells in vitro","volume":"14","author":"Cai","year":"2014","journal-title":"Spine J"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1111\/anae.16433","article-title":"Combined spinal-epidural vs. dural puncture epidural techniques for labour analgesia: a randomised controlled trial","volume":"80","author":"Zang","year":"2025","journal-title":"Anaesthesia"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"13497","DOI":"10.1038\/s41598-025-98142-5","article-title":"Epidemiologic investigation on neurological complications following neuraxial anesthesia in 2.7 million cases in Southwest China","volume":"15","author":"Shu","year":"2025","journal-title":"Sci Rep"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"CD013577","DOI":"10.1002\/14651858.CD013577","article-title":"Epidural corticosteroid injections for lumbosacral radicular pain","volume":"2020","author":"Oliveira","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"i1","DOI":"10.1093\/ageing\/afs200","article-title":"Guidance on the management of pain in older people","volume":"42","author":"Abdulla","year":"2013","journal-title":"Age Ageing"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"261","DOI":"10.36076\/ppj.2017.269","article-title":"Epidural dexamethasone influences postoperative analgesia after major abdominal surgery","volume":"20","author":"Hong","year":"2017","journal-title":"Pain Physician"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"129","DOI":"10.2217\/pmt-2022-0065","article-title":"Epidural dexamethasone for acute postoperative pain management: a systematic review with meta-analysis","volume":"13","author":"Abdildin","year":"2023","journal-title":"Pain Manag"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1093\/bja\/87.4.635","article-title":"Postoperative analgesia by epidural methylprednisolone after posterolateral thoracotomy","volume":"87","author":"Blanloeil","year":"2001","journal-title":"Br J Anaesth"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e4962","DOI":"10.1002\/vetr.4962","article-title":"Effect of local epidural application of methylprednisolone acetate on time to ambulation in non-ambulatory dogs with thoracolumbar intervertebral disc disease: a prospective randomised, blinded control trial","volume":"196","author":"Natsios","year":"2025","journal-title":"Vet Rec"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"451","DOI":"10.5152\/iao.2018.4871","article-title":"Intratympanic methylprednisolone versus dexamethasone for the primary treatment of idiopathic sudden sensorineural hearing loss","volume":"14","author":"Tarkan","year":"2018","journal-title":"J Int Adv Otol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1529","DOI":"10.1042\/CS20171505","article-title":"Defining the role of glucocorticoids in inflammation","volume":"132","author":"Ronchetti","year":"2018","journal-title":"Clin Sci Lond"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"2155","DOI":"10.1007\/s00198-021-05986-4","article-title":"The skeletal consequences of epidural steroid injections: a literature review","volume":"32","author":"Krez","year":"2021","journal-title":"Osteoporos Int"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1097","DOI":"10.1213\/ANE.0000000000000161","article-title":"The effects of glucocorticoids on neuropathic pain: a review with emphasis on intrathecal methylprednisolone acetate delivery","volume":"118","author":"Rijsdijk","year":"2014","journal-title":"Anesth Analg"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.3171\/2023.9.JNS231099","article-title":"The story of dexamethasone and how it became one of the most widely used drugs in neurosurgery","volume":"140","author":"Vazquez","year":"2023","journal-title":"J Neurosurg"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1016\/j.diii.2021.02.007","article-title":"Effectiveness of CT-guided epidural infiltration of steroids and local anesthetics for acute and chronic herpes zoster neuralgia","volume":"102","author":"Beydoun","year":"2021","journal-title":"Diagn Interv Imaging"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"27512","DOI":"10.25011\/cim.v39i6.27512","article-title":"Transient neurological symptoms after spinal anesthesia","volume":"39","author":"Gozdemir","year":"2016","journal-title":"Clin Invest Med"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2022\/4163120","article-title":"Comparison of the efficacy of dexamethasone and methylprednisolone in infiltration injection for Postendodontic pain in patients with necrotic pulp: a randomized controlled clinical trial","volume":"2022","author":"Yeganegi","year":"2022","journal-title":"Pain Res Manag"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1177\/135245859600100607","article-title":"Methylprednisolone treatment in multiple sclerosis: effect of treatment, pharmacokinetics, future","volume":"1","author":"Hommes","year":"1996","journal-title":"Mult Scler"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1122","DOI":"10.1016\/j.bja.2023.12.021","article-title":"Dose-response relationships of intravenous and perineural dexamethasone as adjuvants to peripheral nerve blocks: a systematic review and model-based network meta-analysis","volume":"132","author":"Zufferey","year":"2024","journal-title":"Br J Anaesth"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"2534086","DOI":"10.1080\/07853890.2025.2534086","article-title":"Relatively low plasma cortisol levels in parturients are associated with epidural-related maternal fever","volume":"57","author":"Zhang","year":"2025","journal-title":"Ann Med"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"S1283","DOI":"10.1016\/j.ajog.2022.06.026","article-title":"Epidural-related maternal fever: incidence, pathophysiology, outcomes, and management","volume":"228","author":"Patel","year":"2023","journal-title":"Am J Obstet Gynecol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1785911\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T06:54:37Z","timestamp":1774421677000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1785911\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,25]]},"references-count":25,"alternative-id":["10.3389\/fmed.2026.1785911"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1785911","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,25]]},"article-number":"1785911"}}