Objective: To explore the application of low-concentration ropivacaine (ROP) combined with dexmedetomidine (DEX) for interscalene brachial plexus block (ISB) in patients with hand trauma. Methods: A total of 110 patients with hand trauma confirmed in the hospital were enrolled between January 2022 and December 2024. According to random number table method, they were divided into ROP group (low-concentration ROP for ISB) and ROP+DEX group (low-concentration ROP combined with DEX for ISB), 55 cases in each group. The vital signs, anesthetic effect of drugs, postoperative pain and occurrence of adverse reactions in the two groups were compared. Results: At T0, there was no significant difference in HR, SpO2 or MAP between the two groups (P>0.05). At T1 and T2, there was no significant difference in SpO2 between the two groups (P>0.05), but HR and MAP in ROP+DEX group were higher than those in ROP group (P＜0.01). The onset time of block in ROP+DEX group was faster than that in ROP group, and duration of block and the recovery time were longer than those in ROP group (P＜0.01). At 1h after surgery, there was no significant difference in VAS score between the two groups (P>0.05), but VAS scores in ROP+DEX group were lower than those in ROP group at 6h, 12h and 24h after surgery (P＜0.01). There was no significant difference in the occurrence of adverse reactions (subcutaneous hematoma, arrhythmia, dyspnea, nerve injury) between the two groups (P>0.05). Conclusion: Low-concentration ROP+DEX for ISB is safe and effective in hand trauma surgery, which can shorten onset time of block, improve nerve block effect and prolong analgesic time.