Background Brachial plexus block is frequently performed for ambulatory upper limb surgery as an alternative to general anesthesia. It can significantly reduce pain, reduce post-operative nausea, and vomiting and allowing for faster discharge from hospital. Performing this block under ultrasound guidance has higher index of safety and can monitor the distribution of local anesthetic (LA) in real time. The aim of this study is to compare the block characteristics among bupivacaine-dexmedetomidine (BD), bupivacaine–nalbuphine8 (BN), and bupivacaine-isotonic saline groups. Results The duration of both the sensory and motor blockade was statistically longer in both BD and BN groups with a longer duration of analgesia compared to the BS group. Also, the BD group showed statistically significant higher sedation scores at different times during the study compared with both the BN and BS groups. Conclusion Adding either dexmedetomidine or nalbuphine to isobaric bupivacaine in US-guided supraclavicular brachial plexus block prolongs both sensory and motor blockade. Dexmedetomidine produces significant sedation when added to bupivacaine.

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