Patients scheduled for forearm and hand fracture surgery under an axillary plexus block were randomized to receive the local anesthetic ropivacaine (0.5%) combined with either fentanyl (n=35), dexmedetomidine (n=35), or verapamil (n=35). Outcomes of interest included pain on a visual analogue scale (VAS), duration and time to onset of sensory block, duration and time to achieve motor block, incidence of adverse events, total opioid use, and incidence of side effects. VAS pain was measured at 2, 4, 8, 12, and 24 hours post-surgery. Across all timepoints and groups, there was a significant difference in VAS pain scores (p=0.001), which were lowest within the dexmedetomidine group. Time to onset of sensory block, time to achieve motor block, and the duration for sensory and motor blocks significantly differed with respect to adjuvant treatments (p=0.001). Specifically, patients in the dexmedetomidine group showed the shortest time to onset of sensory block and motor block. Also, patients in the dexmedetomidine group demonstrated the longest duration of sensory and motor blocks. Pairwise comparisons between the groups were not evaluated for any of the analyses. In addition, 1 patient experienced vertigo in the verapamil group and 3 patients experienced vomiting in the fentanyl group.