Epidural Steroid and Clonidine for Chronic Intractable Post‐thoracotomy Pain: A Pilot Study

Ayad, Amany E.; Masry, Ashraf El

doi:10.1111/j.1533-2500.2011.00469.x

Cited by 12 publications

(11 citation statements)

References 21 publications

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“…VAS scores remained maintained between 0 cm and 3 cm from 2 to 5 weeks following epidural catheter removal. Recently, Ayad and El Masry[23] in a pilot study reported that a combination of epidural steroid and clonidine may provide pain relief in chronic post-thoracotomy pain. The findings of afore mentioned studies have been summarized in Table 2.…”

Section: Resultsmentioning

confidence: 99%

Clonidine for management of chronic pain: A brief review of the current evidences

et al. 2014

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Clonidine, an alpha-2 adrenergic receptor agonist, has well-established role in acute perioperative pain management. However, recently it has found increasing use in chronic pain conditions as well. In this review, we systematically searched and analyzed the clinical studies from “PubMed,” “PubMed central” and “Scopus” database for use of clonidine in the chronic pain. Quantitative meta-analysis was not possible as clonidine has been used in various patient populations through different routes. However, qualitative analysis of nearly thirty clinical studies provides some evidence that clonidine administered through epidural, intrathecal and local/topical route may be effective in chronic pain conditions where neuropathy is a predominant component. It may also be effective where opioids are of limited use due to inadequate pain relief or adverse effects.

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Section: Resultsmentioning

confidence: 99%

Clonidine for management of chronic pain: A brief review of the current evidences

et al. 2014

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“…Lauretti et al reported the similar efficacy of epidural clonidine and ketamine in chronic cancer pain [26]. Moreover, Ayad and El Masry [8] reported in a pilot study that a combination of epidural steroid and clonidine may provide pain relief in chronic postthoracotomy pain.…”

Section: Discussionmentioning

confidence: 99%

“…Alpha-2 agonists had been shown to reduce chronic allodynia in rat animal models [6], most probably through blocking pre- and postsynaptic α -2 receptors [7]. The addition of clonidine ( α -2 agonist) to epidural steroid has been used to treat chronic intractable postthoracotomy pain [8]. …”

Section: Introductionmentioning

confidence: 99%

The Effect of Dexmedetomidine on Lumbar Epidural Injection for Failed Back Surgery Syndrome

Eskandr

Maseeh

2016

Anesthesiology Research and Practice

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Purpose. Failed back surgery syndrome is a chronic pain condition requiring rapid, effective, and efficient management. This study evaluates the effect of adding dexmedetomidine to lumbar epidural steroids in patients with failed back surgery syndrome. Methods. Fifty patients suffering from failed back surgery syndrome were randomly assigned to one of two groups, receiving an epidural injection of 20 mL of either a mixture of betamethasone (14 mg) and bupivacaine 0.5 mg (group C) or a mixture of betamethasone (14 mg), bupivacaine 0.5 mg, and dexmedetomidine (0.5 μg/kg) (group D) adjusted to the volume with normal saline. The effect was evaluated using visual analogue scale (VAS), analgesic requirement, and Oswestry disability index 2 weeks, 4 weeks, 8 weeks, and 12 weeks after injection. Results. VAS and ibuprofen consumption showed a significant reduction in group D. The Oswestry disability index was significantly improved in group D. There were no records of hypotension, bradycardia, sedation, or hypoxemia in both groups. Conclusion. The present study demonstrated potential safe and effective usage of adding dexmedetomidine to epidural steroid to control pain in patients with failed back surgery syndrome.

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“…These beneficial effects of clonidine have been demonstrated not only in adult patients but also, in children ( 4 ) and both in patients undergoing general anesthesia ( 1 ), neuraxial block ( 5 - 7 ) and nerve blocks ( 8 ). Even, there are studies that have claimed the role of neuraxial clonidine in decreasing the chronic intractable pain after thoracotomy ( 9 ). But the newly performed studies have claimed that the peripheral and neuraxial effects of clonidine may have some different mechanism of action rather than the previously demonstrated role of clonidine as an alpha 2 adrenoceptor agonist.…”

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confidence: 99%

Clonidine: an old friend newly rediscovered

Dabbagh

2011

Anesth Pain

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Epidural Steroid and Clonidine for Chronic Intractable Post‐thoracotomy Pain: A Pilot Study

Abstract: Our preliminary data suggest possible efficacy of thoracic epidural steroid and clonidine mixture in the treatment of chronic post-thoracotomy pain. No serious adverse effects were noted in this pilot study.

Cited by 12 publications

References 21 publications

Clonidine for management of chronic pain: A brief review of the current evidences

Clonidine for management of chronic pain: A brief review of the current evidences

The Effect of Dexmedetomidine on Lumbar Epidural Injection for Failed Back Surgery Syndrome

Clonidine: an old friend newly rediscovered

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