Efficacy and safety of dexmedetomidine combined with brachial plexus block in shoulder arthroscopy surgery: a meta-analysis_West China Medical Journal

Authors：

 LIU Kai ¹ , ZHANG Huiwei ² , ZHANG Yu ¹

1. Department of Orthopedics, People’s Hosipital of Leshan, Leshan, Sichuan 614000, P. R. China;
2. Department of Anaesthesia, People’s Hosipital of Leshan, Leshan, Sichuan 614000, P. R. China;

Corresponding?author：

LIU Kai, Email: 285061643@qq.com

Keywords：

Dexmedetomidine; brachial plexus block; shoulder arthroscopy

DOI：

10.7507/1002-0179.202604058

Video：

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Objective To investigate the efficacy and safety of dexmedetomidine combined with brachial plexus block in shoulder arthroscopy surgery via meta-analysis. Methods Databases including China National Knowledge Infrastructure, Web of Science, Cochrane Library, Chongqing VIP, PubMed, Wanfang and Embase were searched from databases establishment to July 2026. Randomized controlled trials concerning dexmedetomidine combined with brachial plexus block in shoulder arthroscopy surgery were enrolled. Mean difference (MD) and risk ratio were adopted as effect sizes, and RevMan 5.3 software was used for meta-analysis. Results A total of 9 studies were included. The meta-analysis demonstrated that the dexmedetomidine group had significantly lower postoperative 12-hour Visual Analogue Scale (VAS) scores (MD=–0.72), postoperative 24-hour VAS scores (MD=–0.53), and morphine consumption within 24 hours postoperatively (MD=–14.38 ?mg) compared with the control group (P<0.05). The duration of nerve block was longer in the dexmedetomidine group (MD=2.87?h, P<0.05). There were no statistically significant differences between the two groups in postoperative 48-hour VAS scores, incidence of intraoperative or postoperative bradycardia, and incidence of postoperative nausea and vomiting (P>0.05). Conclusion Current evidence suggests that dexmedetomidine combined with brachial plexus block in shoulder arthroscopy surgery can prolong the duration of nerve block, alleviate pain within 24 hours after surgery, and does not increase complications.

Citation： LIU Kai, ZHANG Huiwei, ZHANG Yu. Efficacy and safety of dexmedetomidine combined with brachial plexus block in shoulder arthroscopy surgery: a meta-analysis. West China Medical Journal, 2026, 41(9): 1485-1488. doi: 10.7507/1002-0179.202604058 Copy

1.	Huan X, Zhang T, Zhou M, et al. Efficacy of perineural dexmedetomidine in ultrasound-guided interscalene block on rebound pain after shoulder arthroscopy[J]. Clin J Pain, 2025, 41(2): e1267.
2.	Toma O, Persoons B, Pogatzki-Zahn E, et al. PROSPECT guideline for rotator cuff repair surgery: systematic review and procedure-specific postoperative pain management recommendations[J]. Anaesthesia, 2019, 74(10): 1320-1331.
3.	Chen HP, Shen SJ, Tsai HI, et al. Effects of interscalene nerve block for postoperative pain management in patients after shoulder surgery[J]. Biomed Res Int, 2015, 2015: 902745.
4.	Yoon SM, Lee A, Choi S. Comparative arthroscopic rotator cuff repair outcomes associated with continuous interscalene block vs. bolus interscalene block with intravenous dexmedetomidine: a retrospective cohort study[J]. J Clin Med, 2025, 14(11): 3882.
5.	Kang RA, Jeong JS, Yoo JC, et al. Improvement in postoperative pain control by combined use of intravenous dexamethasone with intravenous dexmedetomidine after interscalene brachial plexus block for arthroscopic shoulder surgery: a randomised controlled trial[J]. Eur J Anaesthesiol, 2019, 36(5): 360-368.
6.	Bengisun ZK, Ekmek?i P, Akan B, et al. The effect of adding dexmedetomidine to levobupivacaine for interscalene block for postoperative pain management after arthroscopic shoulder surgery[J]. Clin J Pain, 2014, 30(12): 1057-1061.
7.	Abdallah FW, Dwyer T, Chan VW, et al. IV and perineural dexmedetomidine similarly prolong the duration of analgesia after interscalene brachial plexus block: a randomized, three-arm, triple-masked, placebo-controlled trial[J]. Anesthesiology, 2016, 124(3): 683-695.
8.	Kang R, Jeong JS, Yoo JC, et al. Effective dose of intravenous dexmedetomidine to prolong the analgesic duration of interscalene brachial plexus block: a single-center, prospective, double-blind, randomized controlled trial[J]. Reg Anesth Pain Med, 2018, 43(5): 488-495.
9.	Sun ZJ, Wang BQ, Niu ZQ, et al. Dexmedetomidine improves continuous interscalene brachial plexus block in patients after arthroscopic rotator cuff repair[J]. Int J Clin Exp Med, 2018, 11(4): 4168-4172.
10.	Hwang JT, Jang JS, Lee JJ, et al. Dexmedetomidine combined with interscalene brachial plexus block has a synergistic effect on relieving postoperative pain after arthroscopic rotator cuff repair[J]. Knee Surg Sports Traumatol Arthrosc, 2020, 28(7): 2343-2353.
11.	Lee JJ, Kim DY, Hwang JT, et al. Dexmedetomidine combined with suprascapular nerve block and axillary nerve block has a synergistic effect on relieving postoperative pain after arthroscopic rotator cuff repair[J]. Knee Surg Sports Traumatol Arthrosc, 2021, 29(12): 4022-4031.
12.	杜小麗, 胡旭東, 楊淑旋, 等. 右美托咪定復合羅哌卡因臂叢阻滯對肩關節鏡手術后疼痛和炎癥反應的影響[J]. 現代醫院, 2022, 22(7): 1141-1145.
13.	Hamed MA, Fargaly OS, Abdelghaffar RA, et al. The role of dexmedetomidine as an adjuvant for high-thoracic erector spinae plane block for analgesia in shoulder arthroscopy; a randomized controlled study[J]. BMC Anesthesiol, 2023, 23(1): 53.
14.	Vanden Eede H, Noels S, Vreven M, et al. 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[J]. Eur J Anaesthesiol, 2025, 42(9): 808-816.
15.	Zhang Y, Zhao L, Lv L, et al. Retrospective analysis of remifentanil combined with dexmedetomidine intravenous anesthesia combined with brachial plexus block on shoulder arthroscopic surgery in elderly patients[J]. Pak J Med Sci, 2022, 38(6): 1546-1551.
16.	Liu Z, Jiang M, Xu T, et al. Analgesic effect of ropivacaine combined with dexmedetomidine on brachial plexus block[J]. BMC Anesthesiol, 2018, 18(1): 107.
17.	Li HJ, Liu S, Geng ZY, et al. Adding dexmedetomidine to morphine-based analgesia reduces early postoperative nausea in patients undergoing gynecological laparoscopic surgery: a randomized controlled trial[J]. BMC Anesthesiol, 2020, 20(1): 11.
18.	Albrecht E, Capel D, Rossel JB, et al. A randomised controlled trial of intravenous dexmedetomidine added to dexamethasone for arthroscopic rotator cuff repair and duration of interscalene block[J]. Anaesthesia, 2023, 78(3): 315-319.

1. Huan X, Zhang T, Zhou M, et al. Efficacy of perineural dexmedetomidine in ultrasound-guided interscalene block on rebound pain after shoulder arthroscopy[J]. Clin J Pain, 2025, 41(2): e1267.
2. Toma O, Persoons B, Pogatzki-Zahn E, et al. PROSPECT guideline for rotator cuff repair surgery: systematic review and procedure-specific postoperative pain management recommendations[J]. Anaesthesia, 2019, 74(10): 1320-1331.
3. Chen HP, Shen SJ, Tsai HI, et al. Effects of interscalene nerve block for postoperative pain management in patients after shoulder surgery[J]. Biomed Res Int, 2015, 2015: 902745.
4. Yoon SM, Lee A, Choi S. Comparative arthroscopic rotator cuff repair outcomes associated with continuous interscalene block vs. bolus interscalene block with intravenous dexmedetomidine: a retrospective cohort study[J]. J Clin Med, 2025, 14(11): 3882.
5. Kang RA, Jeong JS, Yoo JC, et al. Improvement in postoperative pain control by combined use of intravenous dexamethasone with intravenous dexmedetomidine after interscalene brachial plexus block for arthroscopic shoulder surgery: a randomised controlled trial[J]. Eur J Anaesthesiol, 2019, 36(5): 360-368.
6. Bengisun ZK, Ekmek?i P, Akan B, et al. The effect of adding dexmedetomidine to levobupivacaine for interscalene block for postoperative pain management after arthroscopic shoulder surgery[J]. Clin J Pain, 2014, 30(12): 1057-1061.
7. Abdallah FW, Dwyer T, Chan VW, et al. IV and perineural dexmedetomidine similarly prolong the duration of analgesia after interscalene brachial plexus block: a randomized, three-arm, triple-masked, placebo-controlled trial[J]. Anesthesiology, 2016, 124(3): 683-695.
8. Kang R, Jeong JS, Yoo JC, et al. Effective dose of intravenous dexmedetomidine to prolong the analgesic duration of interscalene brachial plexus block: a single-center, prospective, double-blind, randomized controlled trial[J]. Reg Anesth Pain Med, 2018, 43(5): 488-495.
9. Sun ZJ, Wang BQ, Niu ZQ, et al. Dexmedetomidine improves continuous interscalene brachial plexus block in patients after arthroscopic rotator cuff repair[J]. Int J Clin Exp Med, 2018, 11(4): 4168-4172.
10. Hwang JT, Jang JS, Lee JJ, et al. Dexmedetomidine combined with interscalene brachial plexus block has a synergistic effect on relieving postoperative pain after arthroscopic rotator cuff repair[J]. Knee Surg Sports Traumatol Arthrosc, 2020, 28(7): 2343-2353.
11. Lee JJ, Kim DY, Hwang JT, et al. Dexmedetomidine combined with suprascapular nerve block and axillary nerve block has a synergistic effect on relieving postoperative pain after arthroscopic rotator cuff repair[J]. Knee Surg Sports Traumatol Arthrosc, 2021, 29(12): 4022-4031.
12. 杜小麗, 胡旭東, 楊淑旋, 等. 右美托咪定復合羅哌卡因臂叢阻滯對肩關節鏡手術后疼痛和炎癥反應的影響[J]. 現代醫院, 2022, 22(7): 1141-1145.
13. Hamed MA, Fargaly OS, Abdelghaffar RA, et al. The role of dexmedetomidine as an adjuvant for high-thoracic erector spinae plane block for analgesia in shoulder arthroscopy; a randomized controlled study[J]. BMC Anesthesiol, 2023, 23(1): 53.
14. Vanden Eede H, Noels S, Vreven M, et al. 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[J]. Eur J Anaesthesiol, 2025, 42(9): 808-816.
15. Zhang Y, Zhao L, Lv L, et al. Retrospective analysis of remifentanil combined with dexmedetomidine intravenous anesthesia combined with brachial plexus block on shoulder arthroscopic surgery in elderly patients[J]. Pak J Med Sci, 2022, 38(6): 1546-1551.
16. Liu Z, Jiang M, Xu T, et al. Analgesic effect of ropivacaine combined with dexmedetomidine on brachial plexus block[J]. BMC Anesthesiol, 2018, 18(1): 107.
17. Li HJ, Liu S, Geng ZY, et al. Adding dexmedetomidine to morphine-based analgesia reduces early postoperative nausea in patients undergoing gynecological laparoscopic surgery: a randomized controlled trial[J]. BMC Anesthesiol, 2020, 20(1): 11.
18. Albrecht E, Capel D, Rossel JB, et al. A randomised controlled trial of intravenous dexmedetomidine added to dexamethasone for arthroscopic rotator cuff repair and duration of interscalene block[J]. Anaesthesia, 2023, 78(3): 315-319.

West China Medical Journal

Efficacy and safety of dexmedetomidine combined with brachial plexus block in shoulder arthroscopy surgery: a meta-analysis

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