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

Author

Mylene Louail, Otterbein UniversityFollow

ORCID

https://orcid.org/0009-0001-9760-9351

Date of Award

Spring 5-1-2026

Document Type

Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Advisor

Ruth Chavez, DNP, CNP, FNP-BC, Project Team Lead

First Committee Member

Brian Garret, DNP, CRNA, Team Member

Second Committee Member

Amy Bishop, DNP, AGCNS-BC, Team Member

Third Committee Member

Danielle Winch, DNP, CRNA, Team Member

Keywords

dexmedetomidine, brachial plexus block, opioid reduction, postoperative analgesia, patient satisfaction, upper extremity surgery

Subject Categories

Chemicals and Drugs | Health and Medical Administration | Medical Education | Medicine and Health Sciences | Nursing | Pharmacy and Pharmaceutical Sciences

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.

Acknowledgement 1

1

Acknowledgement 2

1

Licensing Permission

Copyright, all rights reserved. Fair Use

Recommended Citation

Louail, Mylene, "Evidenced-Based Practice Guideline Development: The Addition of Adjunctive Dexmedetomidine in Brachial Plexus Blocks for Upper Arthroscopic Surgery" (2026). Doctor of Nursing Practice Scholarly Projects. 176.
https://digitalcommons.otterbein.edu/stu_doc/176