Saudi journal of anaesthesia
July 2, 2026 · via Europe PMC
Comparison between dexamethasone and dexmedetomidine combined with bupivacaine on pain relief after shoulder arthroscopy: A randomized clinical trial.
Abd El Sabour AI, Attia AMA, Abdelsalam MA, Baset HMA, Ali WN.
AI summary — for doctors, generated from the abstract only
In a randomised trial of patients undergoing shoulder arthroscopy, adding dexmedetomidine rather than dexamethasone to a combined nerve block with bupivacaine provided better pain control and lower opioid consumption over the first 24 hours after surgery.
What was studied
A prospective, double-blind randomized clinical trial at Assiut University Hospital in 60 patients undergoing elective shoulder arthroscopy under general anesthesia, comparing dexamethasone versus dexmedetomidine as an adjuvant to bupivacaine in a combined axillary nerve block and suprascapular nerve block (shoulder block), assessing 24-hour postoperative pain scores (NRS) and opioid consumption.
Key findings
- 60 patients were randomized into equal dexamethasone and dexmedetomidine adjuvant groups, each receiving bupivacaine 0.5% (20 mL) combined with their assigned adjuvant.
- At several time intervals up to 24 hours postoperatively, the dexmedetomidine group showed significantly lower pain ratings than the dexamethasone group.
- The dexmedetomidine group also had lower opioid consumption than the dexamethasone group, though the exact statistical values for this comparison were not fully available in the provided abstract text.
Clinical relevance
This may be relevant to anesthesiologists choosing an adjuvant for shoulder nerve blocks, suggesting dexmedetomidine may provide superior postoperative analgesia and opioid-sparing effects compared with dexamethasone when combined with bupivacaine for shoulder arthroscopy.
Who should care
Limitations
This was a single-center study with a modest sample size (30 patients per group), and some specific statistical values for pain scores and opioid consumption were not fully detailed in the provided abstract text; longer-term outcomes beyond 24 hours were not assessed.
Dexmedetomidine outperformed dexamethasone as an adjuvant for shoulder nerve blocks, providing better pain control and less opioid use in the first day after shoulder arthroscopy.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Postoperative pain management following shoulder arthroscopy remains a significant clinical challenge. Shoulder block modality, which combines axillary nerve block (ANB) with suprascapular nerve block (SSNB), provides analgesia with few reported hazards. Dexamethasone and dexmedetomidine are used as adjuvants to prolong analgesia, but their comparative efficacy remains unclear. This study evaluates their effectiveness with bupivacaine in SSNB and ANB for postoperative pain control.
Patients and methods
This is a prospective, double-blind, randomized clinical study carried out at Assiut University Hospital. The study included 60 patients, between 20 to 65 years old, who were scheduled for elective shoulder arthroscopies under general anesthesia (ASA) class I or II. As an adjuvant to shoulder block in patients undergoing shoulder operations, patients were randomly divided into two equal groups: Dexamethasone group and Dexmedetomidine group. The Dexamethasone group received bupivacaine 0.5% (20 mL) with dexamethasone (4 mg in 1 mL), while the Dexmedetomidine group received bupivacaine 0.5% (20 mL) plus dexmedetomidine (1 mcg/kg in 1 mL). A 24-hour postoperative numerical rating pain scale (NRS) rating and opioid consumption were recorded for both groups.
Results
At several time intervals up to 24 hours postoperatively, patients in the dexmedetomidine group showed lower NRS ratings than those in the dexamethasone group (P P < 0.001). Additionally, the dexmedetomidine group consumed fewer opioids overall.
Conclusion
Dexmedetomidine as an adjuvant in shoulder block provides more postoperative analgesia and lower opioid consumption.
DOI
10.4103/sja.sja_920_25
PMID
42553944
PMCID
PMC13436863
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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