Dexmedetomidine as an Adjuvant to Greater Auricular Nerve Block in Middle Ear Surgeries

This randomized, double-blind, controlled study will evaluate whether adding dexmedetomidine to bupivacaine in an ultrasound-guided greater auricular nerve block prolongs pain relief after middle ear surgery. Adults undergoing elective middle ear surgery under general anesthesia will receive the block before induction, either with bupivacaine alone or with bupivacaine plus dexmedetomidine. The main outcome is how long pain relief lasts after the block. Other outcomes include pain scores, opioid use, emergence agitation, hemodynamic changes, and side effects.