The Analgesic Efficacy of Adding Dexmedetomidine to Ropivacaine in Preoperative Interscalene Block for Arthroscopic Rotator Cuff Repair.
- 1Department of Anesthesiology and Pain, Medical of School, Iran University Medical Science (I. U. M. S) Anesthesiologist and Pain Fellowship Tehran Iran.
Abstract
Background
Effective postoperative pain management is essential after arthroscopic shoulder surgery. Ultrasound-guided interscalene block (ISB) is widely used for perioperative analgesia; however, the benefits of adding dexmedetomidine to local anesthetics remain uncertain.Objectives
This study aimed to evaluate the analgesic efficacy and hemodynamic effects of dexmedetomidine as an adjuvant to ropivacaine for ultrasound-guided ISB in patients undergoing arthroscopic rotator cuff repair.Methods
This double-blind randomized clinical trial included patients aged ≥ 18 years with American Society of Anesthesiologists physical status I-III who were scheduled for elective arthroscopic rotator cuff repair. Forty-two patients were randomly allocated in a 1:1 ratio using a random-number table to receive ultrasound-guided ISB with either 20 mL of 0.25% ropivacaine plus 2 mL of normal saline (R group) or 20 mL of 0.25% ropivacaine plus dexmedetomidine (1.5 μg/kg), diluted to a total volume of 2 mL (ropivacaine-dexmedetomidine (RD) group). Randomization and preparation of the study solutions were performed by an independent investigator. The anesthesiologist performing the block, the patients, and the postoperative outcome assessor remained blinded to the treatment allocation. Pain intensity was assessed using the Numerical Rating Scale (NRS) in the recovery room and at 2, 6, 18, and 24 hours postoperatively. Intraoperative remifentanil consumption, time to the first patient-controlled intravenous analgesia (PCIA) request, number of PCIA requests, pethidine requirements, and hemodynamic variables were recorded. Data were analyzed using the Kolmogorov-Smirnov test, independent-samples t-test, Mann-Whitney U test, chi-square test, or Fisher's exact test, as appropriate.Results
Forty patients completed the study and were included in the per-protocol analysis (20 patients in each group). Compared with the R group, the RD group had significantly lower intraoperative remifentanil consumption (0.11 ± 0.02 vs 0.24 ± 0.04 μg/kg/min, P < 0.001), a longer time to the first PCIA request (17.57 ± 0.93 vs 13.37 ± 1.25 hours after ISB, P < 0.001), fewer PCIA requests (4.50 ± 1.19 vs 9.95 ± 1.50, P < 0.001), a longer time to the first pethidine administration (19.20 ± 0.83 vs 16.33 ± 1.52 hours after ISB, P < 0.001), and fewer pethidine administrations (0.35 ± 0.67 vs 3.45 ± 1.05, P < 0.001). NRS pain scores at 18 and 24 hours were also significantly lower in the RD group. No significant between-group differences were observed in systolic blood pressure, diastolic blood pressure, and heart rate.Conclusions
The addition of dexmedetomidine to ropivacaine for an ultrasound-guided interscalene block significantly prolonged postoperative analgesia, reduced intraoperative remifentanil consumption, decreased postoperative analgesic requirements, and improved postoperative pain control, without significant adverse effects on hemodynamic parameters, in patients undergoing arthroscopic rotator cuff repair.
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BibTeX
@article{alebouyeh2026analgesic,
title = {{The Analgesic Efficacy of Adding Dexmedetomidine to Ropivacaine in Preoperative Interscalene Block for Arthroscopic Rotator Cuff Repair.}},
author = {Mahmood-Reza Alebouyeh and Saeed Reza Entezary and Shirin Zarandooz and Masood Mohseni},
journal = {Anesthesiology and pain medicine},
year = {2026},
month = jun,
doi = {10.5812/aapm-134057},
url = {https://europepmc.org/article/MED/42910144},
note = {CC BY},
}
RIS
TY - JOUR
TI - The Analgesic Efficacy of Adding Dexmedetomidine to Ropivacaine in Preoperative Interscalene Block for Arthroscopic Rotator Cuff Repair.
AU - Mahmood-Reza Alebouyeh
AU - Saeed Reza Entezary
AU - Shirin Zarandooz
AU - Masood Mohseni
PY - 2026
DA - 2026/06/30
JO - Anesthesiology and pain medicine
DO - 10.5812/aapm-134057
UR - https://europepmc.org/article/MED/42910144
AB - Background Effective postoperative pain management is essential after arthroscopic shoulder surgery. Ultrasound-guided interscalene block (ISB) is widely used for perioperative analgesia; however, the benefits of adding dexmedetomidine to local anesthetics remain uncertain.Objectives This study aimed to evaluate the analgesic efficacy and hemodynamic effects of dexmedetomidine as an adjuvant to ropivacaine for ultrasound-guided ISB in patients undergoing arthroscopic rotator cuff repair.Methods This double-blind randomized clinical trial included patients aged ≥ 18 years with American Society of Anesthesiologists physical status I-III who were scheduled for elective arthroscopic rotator cuff repair. Forty-two patients were randomly allocated in a 1:1 ratio using a random-number table to receive ultrasound-guided ISB with either 20 mL of 0.25% ropivacaine plus 2 mL of normal saline (R group) or 20 mL of 0.25% ropivacaine plus dexmedetomidine (1.5 μg/kg), diluted to a total volume of 2 mL (ropivacaine-dexmedetomidine (RD) group). Randomization and preparation of the study solutions were performed by an independent investigator. The anesthesiologist performing the block, the patients, and the postoperative outcome assessor remained blinded to the treatment allocation. Pain intensity was assessed using the Numerical Rating Scale (NRS) in the recovery room and at 2, 6, 18, and 24 hours postoperatively. Intraoperative remifentanil consumption, time to the first patient-controlled intravenous analgesia (PCIA) request, number of PCIA requests, pethidine requirements, and hemodynamic variables were recorded. Data were analyzed using the Kolmogorov-Smirnov test, independent-samples t-test, Mann-Whitney U test, chi-square test, or Fisher's exact test, as appropriate.Results Forty patients completed the study and were included in the per-protocol analysis (20 patients in each group). Compared with the R group, the RD group had significantly lower intraoperative remifentanil consumption (0.11 ± 0.02 vs 0.24 ± 0.04 μg/kg/min, P < 0.001), a longer time to the first PCIA request (17.57 ± 0.93 vs 13.37 ± 1.25 hours after ISB, P < 0.001), fewer PCIA requests (4.50 ± 1.19 vs 9.95 ± 1.50, P < 0.001), a longer time to the first pethidine administration (19.20 ± 0.83 vs 16.33 ± 1.52 hours after ISB, P < 0.001), and fewer pethidine administrations (0.35 ± 0.67 vs 3.45 ± 1.05, P < 0.001). NRS pain scores at 18 and 24 hours were also significantly lower in the RD group. No significant between-group differences were observed in systolic blood pressure, diastolic blood pressure, and heart rate.Conclusions The addition of dexmedetomidine to ropivacaine for an ultrasound-guided interscalene block significantly prolonged postoperative analgesia, reduced intraoperative remifentanil consumption, decreased postoperative analgesic requirements, and improved postoperative pain control, without significant adverse effects on hemodynamic parameters, in patients undergoing arthroscopic rotator cuff repair.
SN - 2228-7523
SN - 2228-7531
ER -