Dexamethasone vs Dexmedetomidine as Adjuncts to Serratus Anterior Plane Block for Post‑MRM Analges

Background and Rationale

The serratus anterior plane block (SAPB) is commonly used to provide postoperative analgesia after breast surgery such as modified radical mastectomy (MRM). Perineural or peribloc adjuvants are often added to local anesthetic solutions to prolong analgesia or reduce opioid requirements. This randomized clinical trial set out to compare two such adjuvants—dexamethasone and dexmedetomidine—when used as adjuncts to SAPB in patients undergoing MRM.

Study Design and Patient Population

According to the PubMed entry, the study was a randomized clinical trial that enrolled 126 female patients undergoing modified radical mastectomy. Participants were allocated equally into two groups: a dexamethasone group (DXA) and a dexmedetomidine group (DMX). The trial report is published in Clin Ter (2026 Sep‑Oct;177[5]:1009–1016) and is available as a free article. The publication lists multiple authors from institutions in Egypt, Saudi Arabia, and the United Kingdom.

Planned Outcomes and Endpoints

The abstract states that measured outcomes included postoperative pain scores, analgesic consumption, and sedation levels. These outcome domains are relevant to assessing the clinical efficacy and tolerability of adjuvants added to SAPB in the MRM setting. The available abstract text is truncated after the word "sedation leve", so the full list of endpoints, time points for assessment, pain scoring instruments, analgesic regimens, and sedation scales are not provided in the source excerpt.

Available Publication Details

The PubMed record provides bibliographic details: Clin Ter. 2026 Sep‑Oct;177(5):1009–1016; DOI 10.7417/CT.2026.2098; PMID 42664118. The trial is designated a Clinical Trial in the PubMed listing. Author affiliations are extensively reported and include departments of anesthesia, intensive care, pain management, and surgery across several universities and hospitals in Egypt, Saudi Arabia, and the United Kingdom.

Missing Data and Limitations in Source Text

The source passage supplied here is an abbreviated PubMed entry with a truncated abstract. As presented, the source identifies study aim, sample size (n=126), randomization into two equal arms (DXA and DMX), and the principal outcome domains. However, critical methodological and results details are not present in the provided text, specifically:

• Exact drug doses, concentrations, volumes, and routes of administration for dexamethasone and dexmedetomidine were not reported in the available excerpt.
• Timing of SAPB relative to induction or surgery, block technique specifics (plane targeted, ultrasound guidance, needle approach), and local anesthetic identity and dose are not reported here.
• Full endpoints, time points for pain and sedation assessment, and validated scales used (for pain and sedation) are not provided in the truncated abstract.
• Numeric results, including postoperative pain scores, cumulative analgesic consumption, time to first rescue analgesia, sedation scores, adverse events, and statistical comparisons (effect sizes and p values) were not included in the available source text.
• Trial registration number, sample size calculation, blinding details, and adverse event reporting are not present in the excerpt.

Because these elements are absent from the supplied PubMed abstract fragment, no conclusions about comparative efficacy, safety, or clinical superiority of one adjuvant over the other can be drawn from this source alone.

Clinical Implications and Next Steps

The trial addresses an important clinical question: whether dexamethasone or dexmedetomidine provides superior augmentation of SAPB for postoperative analgesia after MRM. The available PubMed entry confirms the randomized design and a moderate sample size (126 patients), which may support a meaningful comparison if the full methods and results are robust.

Practitioners wishing to apply these findings should consult the full text to review: dosing regimens, block technique, primary and secondary outcome data, safety and adverse events, and statistical analysis. The PubMed record includes a link to the full text on the journal site (Societa Editrice Universo, srl) for those who need the complete report.

Note on source completeness

This summary strictly reflects the content present in the provided PubMed entry. Because the abstract is truncated in the supplied source, specific numerical outcomes, statistical results, and detailed methodological data were not reported here and therefore were not inferred or added.