Objective To investigate the efficacy and safety of dexmedetomidine combined with brachial plexus block in shoulder arthroscopy surgery via meta-analysis. Methods Databases including China National Knowledge Infrastructure, Web of Science, Cochrane Library, Chongqing VIP, PubMed, Wanfang and Embase were searched from databases establishment to July 2026. Randomized controlled trials concerning dexmedetomidine combined with brachial plexus block in shoulder arthroscopy surgery were enrolled. Mean difference (MD) and risk ratio were adopted as effect sizes, and RevMan 5.3 software was used for meta-analysis. Results A total of 9 studies were included. The meta-analysis demonstrated that the dexmedetomidine group had significantly lower postoperative 12-hour Visual Analogue Scale (VAS) scores (MD=–0.72), postoperative 24-hour VAS scores (MD=–0.53), and morphine consumption within 24 hours postoperatively (MD=–14.38 ?mg) compared with the control group (P<0.05). The duration of nerve block was longer in the dexmedetomidine group (MD=2.87?h, P<0.05). There were no statistically significant differences between the two groups in postoperative 48-hour VAS scores, incidence of intraoperative or postoperative bradycardia, and incidence of postoperative nausea and vomiting (P>0.05). Conclusion Current evidence suggests that dexmedetomidine combined with brachial plexus block in shoulder arthroscopy surgery can prolong the duration of nerve block, alleviate pain within 24 hours after surgery, and does not increase complications.
