72 patients undergoing surgery for transforaminal lumbar interbody fusion were randomized into ropivacaine alone (R; n=18), or ropivacaine plus either dexamethasone (R-DXM; n=18), dexmedetomidine (R-DEX; n=18), or dexamethasone and dexmedetomidine (R-DXM+DEX; n=18). The primary outcome of interest was the duration of analgesia. Secondary outcomes included the incidence of adverse events, hydromorphone consumption, and pain at rest and with movement on a Numeric Rating Scale (NRS). Duration of analgesia, total hydromorphone consumption, and NRS pain scores at rest and with activity, were all similar between the four groups. The R-DEX and R+DXM+DEX groups showed significantly more delays in anesthesia recovery compared to the R-DXM and R groups. All other adverse events were similar between the groups.