Albrecht E, et al. - Researchers analyzed 50 trials comparing the combination of perineural dexamethasone or dexmedetomidine with local anesthetics (LA) to LA alone for peripheral nerve block (PNB), to determine the superior adjunct between dexamethasone and dexmedetomidine. This would help inform current practice and future research. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. The primary outcome was the duration of analgesia and secondary outcomes were sensory and motor block durations, sensory and motor block onset times, and the risks of hypotension, sedation, and neurological symptoms. In indirect meta-analysis, 49 trials (3019 patients) were included. The prolongation of sensory/motor blockade with both adjuncts was similar, as reported by low-quality evidence. However, the possible superiority of dexamethasone was reflected by its ability to improve the duration of analgesia by a statistically significant increase without conferring the risks of hypotension or sedation. This analgesic effect was although clinically modest, was equivalent to 2.5 hours more than dexmedetomidine.