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Background and Objectives: Intravenous (IV) dexamethasone or dexmedetomidine is reported to prolong the duration of analgesia after single-shot interscalene brachial plexus block (ISBPB). However, the effect of coadministration of these agents on the duration of analgesia has not been evaluated. Therefore, we evaluated the difference in time to first rescue analgesic request between patients receiving coadministered IV dexamethasone and dexmedetomidine and patients receiving IV dexamethasone alone after single-shot ISBPB for arthroscopic shoulder surgery. Methods: Sixty-six patients undergoing arthroscopic shoulder surgery with ISBPB with 15 ml of 0.5% ropivacaine with 1:200,000 epinephrine were randomly assigned to one of three groups: (1) IV normal saline (control, n=22), (2) IV dexamethasone 0.11 mgu00b7kg-1 (D1, n=22), (3) IV dexamethasone 0.11 mgu00b7kg-1 and IV dexmedetomidine 1.0 u03bcgu00b7kg-1 (D2, n=22). The primary outcome was the time to first rescue analgesic request. Results: The median (interquartile range) time to first rescue analgesic request was significantly longer for the D2 group (66.3h [23.3 to 72]) than the D1 (17.4h [14.9 to 36], P=0.002) and control (10.9h [10.1 to 12.2], P