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Background and Aims This study aimed to evaluate the effects of dexmedetomidine and dexamethasone, used as adjuvants in ultrasound-guided infraclavicular blocks, on block onset time, block duration, analgesic requirement, and adverse events in patients undergoing upper extremity surgery.Methods This prospective observational study included 44 patients undergoing upper extremity surgery. They were divided into two equal groups: Group A (dexmedetomidine, n=22) and Group B (dexamethasone, n=22). Variables recorded included hospital stay duration, onset and duration of sensory and motor block, time to first analgesic requirements, 24-hour postoperative analgesic need, hemodynamic parameters (HR, MAP, SpO 2), Ramsay Sedation Score (RSS), VAS scores, and complications.Results Demographics were similar between groups Hospital stay and block onset times were significantly shorter in the dexmedetomidine group (p<0.001). Although block durations were also shorter in this group (p=0.003, p=0.023), the time to first analgesic was earlier and all patients (100%) required analgesia postoperatively, compared to only 5 patients (22.7%) in the dexamethasone group (p<0.001). VAS scores were comparable at T0-T2 but significantly higher in the dexmedetomidine group at T3 and T4. RSS scores were also significantly higher at later time points, indicating greater sedation. Bradycardia was observed in 5 patients in the dexmedetomidine group and 1 in the dexamethasone group. No nausea, vomiting, hypotension, or nerve injury was observed.Conclusions The choice between these two adjuvants may depend on the clinical context: dexmedetomidine may be preferred for rapid onset and intra-operative sedative effects, whereas dexamethasone may be more suitable for prolonged post-operative analgesia. Further comprehensive studies are needed to guide adjuvant selection, optimise dosing strategies, and explore their use in other types of regional anaesthesia.