Kahn RL, et al. - Given perineural dexamethasone and intravenous (IV) dexamethasone have been shown to prolong peripheral nerve block duration but the effects of perineural and IV dexamethasone have only been compared at doses of 4 mg or greater, researchers determined the impact of 1 mg IV vs perineural dexamethasone on interscalene block (ISB) analgesia duration in this triple-blind, randomized trial including patients undergoing ambulatory shoulder arthroscopy. They found that low-dose perineural dexamethasone (1 mg) in combination with 15 mL of 0.5% bupivacaine, vs 1 mg IV dexamethasone, prolonged the median time until pain relief from the ISB completely wore off. However, compared to the a priori–defined minimal clinically meaningful difference of 5 hours, a smaller degree of prolongation was observed.