The analgesic effect of epidural clonidine after spinal surgery: a randomized placebo-controlled trial.

Abstract:

BACKGROUND:Clonidine is an alpha(2) adrenoreceptor and imidazoline receptor agonist, which has analgesic, sedative, and minimum alveolar anesthetic concentration-sparing effects. It has been used orally, IV, and epidurally. In spinal surgery, there is a reluctance to use local anesthetic-based epidural analgesia postoperatively because of fears of masking important signs of nerve root or spinal cord injury. METHODS:We randomized 66 patients undergoing uncomplicated decompressive spinal surgery to receive an epidural infusion of either clonidine (Group C) or saline placebo (Group P) postoperatively. Morphine consumption by patient-controlled analgesia device was recorded for 36 h. RESULTS:Morphine consumption was significantly lower in Group C. The mean consumption at 36 h was 35 mg (95% confidence interval 21-50 mg) in Group C, compared with 61 mg (95% confidence interval 48-74 mg) in the control group. Nausea was significantly reduced in Group C (6.5%), when compared with placebo (38.2%). CONCLUSION:Low-dose epidural clonidine significantly reduced the demand for morphine and reduced postoperative nausea with few side effects.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Farmery AD,Wilson-MacDonald J

doi

10.1213/ane.0b013e31818e61b8

subject

Has Abstract

pub_date

2009-02-01 00:00:00

pages

631-4

issue

2

eissn

0003-2999

issn

1526-7598

pii

108/2/631

journal_volume

108

pub_type

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