Evidenced-Based Practice Guideline Development: The Addition of Adjunctive Dexmedetomidine in Brachial Plexus Blocks for Upper Arthroscopic Surgery

Abstract

Dexmedetomidine (DEX) is an alpha-2 adrenergic agonist increasingly studied as an adjunct in brachial plexus blocks (BPBs) to enhance postoperative pain management. This project examines the efficacy of DEX as an adjunct in BPBs for upper extremity arthroscopic surgeries, focusing on its ability to extend analgesia duration, reduce opioid use, and enhance patient satisfaction. With analgesic and sedative properties, DEX can improve postoperative pain management with minimal side effects, providing shortened hospital stays, decreased costs, and better patient outcomes. Using the Iowa Model for evidence-based practice, baseline data on postoperative pain, analgesia duration, and opioid use will be collected from patients receiving standard BPBs, establishing control metrics. During the trial, 50 patients will be randomized to receive DEX-adjunct BPBs or standard BPBs with lidocaine. Key outcomes, including analgesia duration and opioid consumption, will be analyzed with two-sample t-tests, and logistic regression will be used to assess binary outcomes of opioid use. Patient satisfaction, measured via Likert scale surveys, will be evaluated using descriptive statistics and t-tests. Preliminary evidence suggests that DEX can significantly reduce pain and opioid consumption postoperatively. This study aims to confirm these benefits with a Quality Improvement (QI) review to ensure protocol adherence and data quality through chart audits and electronic medical record (EMR) reviews. Findings will be shared with stakeholders and published in medical journals to promote DEX’s use in BPBs. If successful, the project could lead to broader adoption of DEX in BPBs