Friday, September 28, 2012

Epidural Clonidine as the sole anesthetic for abdominal surgery


Dr. Waxer

A.A. Abd-Elsayed, S. Zaky
Epidural Clonidine as a sole analgesic agent during and after abdominal surgery
University of Cincinnati, Cincinnati, Anesthesiology, Cleveland Clinic, Cleveland, OH, USA

Clonidine is a well known agent that can provide analgesia with epidural anesthesia.  If this is so widely known, then why do people not use clonidine more regularly with epidural anesthesia?

In a study conducted by Dr. Abd-Elsayed and colleagues from the University of Cincinnati Academic Health Center, 40 ASA I-II patients aged 18-50 whom had elective lower abdominal surgery were studied.  Patients were randomized into receiving either epidural clonidine or epidural bupivacaine for supplemental anesthesia.  As it turns out, pain scores were found to be significantly lower in the patients who received clonidine.  With reduced postoperative nausea, vomiting and urinary retention in the clonidine group when compared with bupivacaine.  From Dr. Abd-Elsayed, “Clonidine was very effective at controlling pain and hemodynamic parameters in our patients.”

With such promising results, it certainly does beg a question; why do the majority of anesthesia providers no longer use clonidine on a regular basis for epidural anesthesia?

Perhaps this will be the beginning of a new resurgence in the use of clonidine for epidural analgesia.   

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