Efficacy of Non-weight Based, Low Dose Dex-Dex Adjuncts in Prolonging Peripheral Nerve Blocks

Inclusion Criteria: * Healthy adults (18 years and older but less than 75) * Speaks and understands English. * Capable of performing all activities of daily living independently * Normal development for age and without cognitive impairment * Weight over 50 kg * Undergoing scheduled, elective foot, ankle, and shoulder surgery * Patient is not expected to perform weight-bearing rehabilitation post-op for 1 week. * Regular access to the internet Exclusion Criteria: * Under 18 or older than 75 years of age * Pregnancy * Known allergy to local anesthetics including lidocaine and ropivacaine. * Known allergy to glucocorticoid steroids or necessary abstinence for medical reasons. * Known allergy to dexmedetomidine or other α2 agonist derivatives. * Severe organ dysfunction: end-stage renal disease, liver failure * Severe psychiatric disease that alters sense of reality and interferes with pain perception. * Severe cognitive impairment that interferes with pain perception * Chronic opioid use, alcohol abuse, or any other substance abuse * Urgent/emergent procedure * Emergency return to OR after initial surgery * Infection at block or surgical site * Hemodynamic instability preoperatively * Hemodynamic instability during surgery affects timely extubating at the end of surgery. * Failed nerve blocks that did not end up blocking the nerves as intended, or inadequate nerve blocks requiring repeat rescue blocks in PACU.