Is Neuraxial Clonidine a Safer Alternative to Opioids for Chronic Pain? An Alternative Worth Exploring

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Author Info

Nagy Mekhail Shrif Costandi Alaa Abd-Elsayed Gregory Fiore Jijun Xu Lou-Anne Acevedo-Moreno Leonardo Kapural Ali R. Rezai Chris Gilligan

Corresponding Author

Nagy Mekhail
Evidence-Based Pain Management Research, Cleveland Clinic, Cleveland, Ohio, USA

A B S T R A C T

Objective: Exploring the potential role of clonidine as an alternative to the currently available neuraxial medication options for the management of chronic pain. Methods: A comprehensive literature search was conducted investigating the treatment of chronic pain using clonidine over the past 73 years. A stepwise filtering approach was used to obtain articles addressing neuraxial treatment of chronic pain in adults. Selected articles were assessed for their levels of evidence followed by a discussion of their contribution to the understanding of the role of clonidine in chronic pain management. Results: Out of 1,035 articles that described the administration of clonidine for chronic pain management, seven articles met all of the inclusion criteria. Their levels of evidence ranged from 1a to 4 (Oxford Centre CEBM). Neuraxial administration of clonidine was found to be effective in the treatment of chronic pain, often exhibiting a synergistic effect with other analgesics to provide pain reduction with reduced opioid use. The most common side effect was hypotension, in some cases reported to have been serious. Conclusion: The use of neuraxial clonidine, in either a primary or adjunctive role, appears promising as an effective treatment for chronic pain.

Article Info

Article Type

Research Article

Publication history

Received: Sat 01, Aug 2020
Accepted: Fri 14, Aug 2020
Published: Mon 24, Aug 2020

Copyright

© 2023 Nagy Mekhail. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.NNB.2020.03.09