The study compared the effectiveness of two adjuvant medications added to bupivacaine in erector spinae plane block for pain relief after arthroscopic shoulder surgeries. The tested medications were fentanyl and dexmedetomidine, each at a dose of 1 microgram per kilogram of body weight. The base medication in the block was bupivacaine at a concentration of 0.25 percent. The research was conducted at Tanta University and aimed to determine which combination provides better postoperative analgesia. The study has been completed and its results have the potential to improve pain management in patients after shoulder operations.