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Anesth Analg 2009; 108:631-634
© 2009 International Anesthesia Research Society
doi: 10.1213/ane.0b013e31818e61b8
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ANALGESIA

The Analgesic Effect of Epidural Clonidine After Spinal Surgery: A Randomized Placebo-Controlled Trial

Andrew D. Farmery, BSc, BS, MA, MD, FRCA*, and James Wilson-MacDonald, MCh, FRCS{dagger}

From the Nuffield Departments of *Anaesthetics and {dagger}Orthopaedic Surgery, University of Oxford, Oxford, UK.

Address correspondence and reprint requests to Andrew D. Farmery, Nuffield Department of Anaesthetics, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK. Address e-mail to andrew.farmery{at}nda.ox.ac.uk.

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.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 2009 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2009 by the International Anesthesia Research Society.