TY - JOUR
AR - NNB-2020-3-109
TI - Is Neuraxial Clonidine a Safer Alternative to Opioids for Chronic Pain? An Alternative Worth Exploring
AU - Nagy, Mekhail
AU - Shrif , Costandi
AU - Alaa , Abd-Elsayed
AU - Gregory , Fiore
AU - Jijun , Xu
AU - Lou-Anne , Acevedo-Moreno
AU - Leonardo , Kapural
AU - Ali R. , Rezai
AU - Chris , Gilligan
JO - Neurology and Neurobiology
PY - 2020
DA - Mon 24, Aug 2020
SN - 2613-7828
DO - http://dx.doi.org/10.31487/j.NNB.2020.03.09
UR - https://www.sciencerepository.org/is-neuraxial-clonidine-a-safer-alternative-to-opioids-for-chronic_NNB-2020-3-109 
KW - Clonidine, neuraxial, epidural, intrathecal, chronic pain
AB - 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.