Dexamethasone versus Dexmedetomidine as Adjuvants to Bupivacaine in Erector Spinae Plan Block in Shoulder Arthroscopy | ||
| Medicine Updates | ||
| Articles in Press, Accepted Manuscript, Available Online from 28 September 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/muj.2025.419304.1258 | ||
| Authors | ||
| Asmaa Sedeek Osman* 1; Magdy Aly Omera2; Mohammed Nassef Elsayed3; Nashwa Ahmed4 | ||
| 1Anesthesia and intensive care resident faculty of medicine Port said university | ||
| 2professor of Anesthesia and intensive care faculty of medicine Port said university | ||
| 3Lecturer of Anesthesia and Intensive Care Faculty of Medicine - Port Said University | ||
| 4Lecturer of Anaesthesia and Surgical Intensive Care, Faculty of Medicine, Port Said University, Port Said, Egypt. | ||
| Abstract | ||
| Abstract Background: Shoulder arthroscopy often causes severe pain postoperatively. The erector spinae plane block (ESPB) offers effective analgesia, and adjuvants like dexmedetomidine and dexamethasone can prolong its effect. This study aimed to evaluate the effectiveness of dexmedetomidine and dexamethasone as adjuvants to bupivacaine in ESPB for shoulder arthroscopy. Methods: This was a randomized, single-blind clinical trial. Fifty patients aged 18–65 years classified as ASA I–II with BMI <40 kg/m² undergoing elective shoulder arthroscopy at El Salam Hospital (Port Said) and Suez Canal University Hospital (Ismailia), Egypt, between November 2024 and May 2025, were included. Patients were randomized into two equal groups: Group 1 (dexamethasone): ESPB with 4 mg (1 ml) dexamethasone + 20 ml bupivacaine 0.25%; Group 2 (dexmedetomidine): ESPB with 100 µg dexmedetomidine + 20 ml bupivacaine 0.25%. Results: The motor block duration was longer in group 2 in comparison to group 1 (P=0.005). Time to first request for rescue analgesia was longer in group 2 than in group 1 (P<0.05). Consumption of total nalbuphine within the first 24 hours was lower in group 2 than in group 1 (P<0.001). The visual analogue scale (VAS) scores were also lower at 12 and 18 h in group 2 in comparison to group 1 (P<0.05). Postoperative nausea , bradycardia, hypotension, and block failure were insignificantly different between the two groups. No cases of local anesthetic (LA) toxicity were reported in either group. Conclusions: Dexmedetomidine offered superior analgesic outcomes compared with dexamethasone as adjuvants to bupivacaine in ESPB for shoulder arthroscopy. | ||
| Keywords | ||
| Dexamethasone; Dexmedetomidine; Bupivacaine; Erector Spinae Plan Block | ||
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