Efficacy of adding clonidine to intrathecal morphine in acute postoperative pain: meta-analysis

Abstract

The addition of clonidine to intrathecal morphine extends the time to first analgesia and decreases the amount of morphine used. However, as the effects are small, and the results heavily influenced by a study in which intrathecal fentanyl was also given, this must be balanced with the increased frequency of hypotension.

Effect of Clonidine and/or Fentanyl in Combination with Intrathecal Bupivacaine for Lower Limb Orthopedic Surgeries in Spinal Anaesthesia

“…Recently, there are few studies which report beneficial effects of using 30 or even 15 mcg of intrathecal clonidine with minimal adverse effects. 33,44 possibly; further reducing the dose of clonidine could have elucidated dose-response relationship.…”

Effect of Different Doses of Dexmedetomidine as Adjuvant in Bupivacaine -Induced Subarachnoid Block for Traumatized Lower Limb Orthopaedic Surgery: A Prospective, Double-Blinded and Randomized Controlled Study

“…Local anaesthetics alone for subarachnoid block provide good operative conditions but have shorter duration of postoperative analgesia. So various drugs like opioids [7], epinephrine [8], neostigmine [9], magnesium [10], midazolam [11], ketamine [12], and clonidine [13] have been used as adjuvant to intrathecal local anaesthetics to achieve quick, dense and prolonged block, but the results were associated with side effects.…”

“…Diverse classes of drugs such as opioids [7], epinephrine [8], neostigmine [9], magnesium [10], midazolam [11], ketamine [12], and clonidine [13] have been added to intrathecal local anaesthetics in an attempt to prolong analgesia and reduce the incidence of adverse events.…”

Preparative Separation and Structural Identification of Impurities of a New α2‑Adrenoceptor Agonist Using Stacking Injection, LC-MSn and LC-SPE-NMR

“…α 2 -Adrenoceptors agonists are compounds that have been used as adjuvant drug to improve therapeutic efficacy and the duration of action of drugs used for pain treatment like morphine. [22][23][24] The main advantage of simultaneous use of an adjuvant compound is to reduce the dose and frequency of administration of the main active drug, thus reducing side effects. 22,23,25 Clonidine, a centrally acting α 2 -adrenoceptor agonist, is administrated as an adjuvant of analgesic and hypnotic compounds.…”

“…However, its main disadvantages are the incidence of hypotension. 23,[26][27][28] Therefore, the discovery of new drugs with properties similar to clonidine, but hemodynamically more stable is clinically relevant. A synthetic compound, 3-(2-chloro-6-fluorobenzyl)-imidazolidine-2,4-dione, named LPSF-PT-31, Girsupan ( Figure 1) is a new α 2 -adrenoceptor agonist with an analgesic and sedative profile, which has showed dosedependent antinociceptive effects via α 2 -adrenoceptor activation and improved stability of blood pressure and heartbeat rate when compared to clonidine.…”