Author

Study Design

Patient Population

N of Patients

Study Groups/Dosage

Conclusions

Level of evidence

Ackerman
(2003)

Retrospective

CRPS, Neuropathic pain, Cancer pain.

15

10/15 patients with >50% pain relief on a single-dose clonidine injection(25-50 mcg), received a continuous intrathecal clonidine infusion (75-950 mcg/day) with a failure of pain relief ranging from 3-11 months.

Intrathecal clonidine is relatively safe and well tolerated, but as monotherapy did not pro-

vide good pain relief in our series.

2b

Eisenach
(1995)

Double-blind RCT

Neuropathic, Somatic/Visceral cancer pain

85

30 mcg/h epidural clonidine or placebo continuously for 14 days.

Successful analgesia with epidural clonidine was higher than placebo (45 vs 21%).

1b

Glynn
(1996)

Double-blind, crossover

Low back and leg pain, neuropathic pain, pelvic pain and  Wegner's granulomatosis

20

Lumbar epidural clonidine (150 mcg), lidocaine (40 mg) and combination of clonidine (150 mcg) and lidocaine (40 mg), all drugs were given in a volume of 3 ml.

Epidural clonidine had a supra-additive effect and behaved more like a co-analgesic than a pure analgesic.

1b

Rauck
(2015)

Double-blind, crossover

Hyperalgesia and Allodynia in CRPS

22

2 groups: Intrathecal clonidine 100 mcg or adenosine 2 mg.

Intrathecal clonidine and adenosine both significantly reduced pain and areas of hyperalgesia and allodynia in patients with CRPS.

1b

Rauck
(1993)

Randomized, blinded, placebo-controlled

CRPS (RSD)

26

Random order on 3 consecutive days, epidural injection of clonidine, 300 or 700 micrograms, or placebo. Patients who responded to clonidine, received continuous epidural infusion of clonidine (10 - 50 mcg/h) for 43 days.

Clonidine produced pain relief, sedation, and decreased blood pressure and heart rate after bolus epidural injection. The smaller clonidine dose (300 mcg), produced pain relief similar to those of the 700 mcg dose.

1b

Siddall
(2000)

Double-blind RCT

Neuropathic pain after spinal cord injury

15

Day 1: Saline, 0.2 - 1.0 mg of morphine, or 50 - 100 mcg of clonidine. Day 2: Increased dose of the same drug (1.5 times the initial dose). Day 3: Two times the initial dose.

Intrathecal administration of a mixture of clonidine and morphine is more effective than either drug administered alone.

1b

Van Melkebeke

(1995)

Case report

Neuropathic pain after arm trauma

1

Intrathecal pump: 250 mcg morphine hydrochloride and 19 mcg clonidine daily.

Patient was pain-free for over two years using the same medication dosages.

4