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

Review Data

Q: Is the topic relevant to the journal area of interest? Is it contemporary and interesting for researchers?

A: Very good

Abstract & Keywords

Q: Are all required components included in the abstract? Are the keywords appropriately chosen?

A: Very good

Goal

Q: Is the goal explicitly stated in the Introduction? Is its formulation clear and unambiguous?

A: Good

Structure

Q: Is the paper's structure coherent? Is it in coherence with the goal of the paper?

A: Very good

Tools and Methods

Q: Are methods the author uses adequate and well used?

A: Good

Discussion & Conclusion

Q: Is it related to the results presented before? Do you consider them as coherent?

A: Good

Comments:

The Results comprise findings from seven randomized studies including controlled trials, retrospective study and a case report. Both efficacy and side effects of clonidine treatment are well covered in the Discussion section. The study led to the Conclusion that neuraxial clonidine could be an asset medication included in the treatment algorithm for chronic neuropathic pain avoiding significant side effects associated with opioids. Further, large and well controlled studies in future are needed to substantiate the therapeutic benefits of clonidine for treatment of pain and to standardize its proper dosage for different routes of administration.

Literature

Q: Does the author utilize relevant literature?

A: Very good

Author's knowledge

Q: What is the level of the author’s knowledge? Does the author utilize all recent contributions relevant to the topic?

A: Excellent

Length

Q: Is the length of the paper adequate to the significance of the topic? Do you suggest shortening the paper without losing its value?

A: Good

Figures & Tables

Q: Does the author use them suitably? Are legend and notations clear?

A: Good

Writing style

Q: Is it clear and understandable?

A: Good

Further comments on the paper

Comments: This study explores the potential role of clonidine as an alternative to the currently available neuraxial medication options for the management of chronic pain. A literature search was carried out investigating the treatment of chronic pain using clonidine over the past 73 years. Clonidine is a promising option in the pain management paradigm with several major advantages over opioids including the lack of addiction risk and is valuable when used to treat chronic pain patients who are opioid-tolerant, opioid non-responsive or allergic to opioids. The main limitations of this study are the scarcity of clinical trials assessing neuraxial clonidine as the sole medication for pain control and unanswered questions of long-term pain relief as well as comparison of clonidine alone vs placebo for the treatment of chronic pain.

Q: Would you recommend this manuscript for further publication?

A: Yes - Suitable to be published

If you have any questions and clarifications you can write to the journal.

Thanks,
Science Repository Team