• Xiang Huan, Ting Zhang, Meiyan Zhou, and Liwei Wang.
• Department of Anesthesiology and Pain Clinic, Xuzhou Central Hospital, NO.199 South Jiefang Roud, Xuzhou, Jiangsu Province, China.
• Clin J Pain. 2024 Dec 17.

ObjectivesThis prospective, randomized, double-blind trial was performed to investigate the effect on rebound pain incidence of mixing dexmedetomidine (DEX) with local anesthetics in a combined injection interscalene block (ISB) during shoulder arthroscopy.Methods47 patients were enrolled in this study. Patients were randomly assigned to 2 groups: Group DEX and Group Control received ultrasound-guided ISB using 12 mL of 0.5% ropivacaine with 50 ug of dexmedetomidine or without dexmedetomidine. Pain scores at 6, 12, 24, 48 h after surgery were assessed with Numeric Pain Rating Scale (NRS). Additional analgesic requirements and side effects in the first 48h postoperatively, as well as sleep disturbance on the night and other complications of surgery were examined.ResultsThe incidence of rebound pain was lower in the group DEX than in the Control group. Perineural DEX decreased pain scores at 12 h and 24 h postoperatively. Group DEX had a prolonged time to first analgesic request, PCA sufentanil consumption in group DEX was less than group Control during the first 48 hours postoperatively. The number of patients with sleep disturbance and nausea and vomiting in the DEX group was lower on the first night postoperative.DiscussionPerineural dexmedetomidine added to ISB exerts beneficial effect on the incidence of rebound pain after ISB in patients with pain catastrophizing undergoing shoulder arthroscopy. Perineural dexmedetomidine facilitated the implementation of multimodal analgesia in the early stage after operation.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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