Comparative Study Between Dexamethasone Versus Dexmedetomidine as Adjuvant to Bupivacaine in Ultrasound Guided Suprascapular Nerve Block for Postoperative Analgesia in Shoulder Surgeries

Background: It is common to need to administer substantial dosages of opioids to alleviate the acute postoperative pain that follows shoulder procedures, even when using multimodal analgesia regimes. While nonsteroidal anti-inflammatory drugs (NSAIDs) influence the digestive, liver, and kidney systems as well as wound healing, this can cause a number of unwanted side effects, including irritation, respiratory impairment, postoperative motion sickness, and vomiting. Aim: Using variables including sensory blockade length and postoperative analgesia, this study will compare the two adjuvants on suprascapular nerve blocks (SSNB): bupivacaine plus dexamethasone and bupivacaine plus dexmedetomidine. One of the secondary goals is to measure the amount of analgesics used and the pain score after surgery. Subjects and methods: Between 2022 and 2024, 60 patients admitted to Al-Hussein and Sayed Galal University Hospitals as part of Al-Azhar University's elective shoulder surgery program participated in this prospective randomized double-blind controlled trial. Results: There was no statistically significant difference in interleukin-6 levels between groups A and B, and all three groups were significantly lower than group C at 6 and 12 hours. Among the three groups, not a single patient experienced pneumothorax. The three groups did not differ significantly with respect to hematoma, PONV, bradycardia, or hypotension. Conclusion: Dexmedetomidine is a more effective adjuvant than dexamethasone when combined with bupivacaine in SSNB for shoulder surgeries, offering prolonged sensory blockade, delayed need for rescue analgesia, and reduced analgesic consumption. While both adjuvants improved postoperative pain control compared to bupivacaine alone.