Intravenous dexmedetomidine as addition to dexamethasone for interscalene brachial plexus block for postoperative analgesia after arthroscopic shoulder surgery: A randomised, double-blinded, single centre trial
Authors' conclusion
Administering high doses of intravenous dexmedetomidine may not yield additional analgesic benefits after single-shot interscalene brachial plexus block while potentially increasing haemodynamic risks and prolonging time to extubation.
Study context
- Population
- Patients undergoing arthroscopic shoulder surgery with single-shot interscalene brachial plexus block
- Participants
- 218 patients
- Comparison
- IV dexmedetomidine 1.0, 1.5 or 2.0 μg kg −1 vs IV 0.9% saline, added to dexamethasone after interscalene brachial plexus block
- Primary endpoint
- Time to first analgesic request (h)
Methodological detailsdouble-blind, single-centre, blocked randomisation, Single-centre, November 2021 to December 2023
- Double-blind
- Single-centre
- Blocked randomisation
- Single-centre, November 2021 to December 2023
Primary result
As reported in the abstract
Further findings
PONV, patient satisfaction and quality of sleep · first 24 h
- No significant difference
Safety
| Outcome | OR (95% CI) | |
|---|---|---|
| Time to extubationGroup 4 vs Group 1 | 0.98 (0.96–0.99) | |
| 0.512Odds ratio (log scale) |
- Time to extubation: prolonged time to extubation (>14 min) when duration of surgery shorter
Intra-operative hypotension and bradycardia
- Significant differences between control and all dexmedetomidine groups combined
- Study not powered for this analysis
Time to extubation
- Time to extubation significantly higher in group 4
Original publication
Intravenous dexmedetomidine as addition to dexamethasone for interscalene brachial plexus block for postoperative analgesia after arthroscopic shoulder surgery: A randomised, double-blinded, single centre trial. Eur J Anaesthesiol. Published 13 May 2025. doi:10.
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