Dexamethasone Versus Dexmedetomidine as Adjuncts to Serratus Anterior Plane Block for Postoperative Analgesia After Modified Radical Mastectomy: A Randomized Clinical Trial.

Abstract

Background: Serratus anterior plane block (SAPB) is widely used for postoperative analgesia following modified radical mastectomy (MRM). Adjuvant drugs such as dexamethasone and dexmedetomidine may enhance its efficacy. Objective: To compare the analgesic efficacy of dexamethasone versus dexmedetomidine as adjuncts to SAPB in patients undergoing MRM. Methods: This randomized clinical study included 126 female patients undergoing MRM, allocated into two equal groups: dexamethasone (DXA) and dexmedetomidine (DMX). Outcomes included postoperative pain scores, analgesic consumption, sedation level, adverse effects, and recovery parameters. Results: The DXA group demonstrated significantly lower postoperative pain scores at all time points (p < 0.05), prolonged time to first rescue analgesia, reduced opioid consumption, shorter hospital stay, and lower chronic pain scores. Early postoperative sedation scores were higher in the DXA group but without clinical significance. No significant differences were observed in adverse effects between groups. Conclusion: Dexamethasone is superior to dexmedetomidine as an adjunct to SAPB in MRM, providing prolonged analgesia and improved recovery outcomes.