Clonidine as an adjunct to intrathecal bupivacaine: An integrative review
View File(s)
Aims and objectives: The aim of this integrative review is to provide current, evidence-based anesthetic recommendations for the use of clonidine as an adjuvant to bupivacaine for patients undergoing total knee arthroplasty (TKA) under spinal anesthesia.
Methods: Articles published between 1993 and 2018 were critically appraised for validity and reliability of the studies. It is important to note that literature was searched for publications between 1993 and 2022, however nothing relevant to this topic was published between 2019-2022.
Results: Clonidine is a selective partial alpha 2 receptor agonist.1 When administered in the intrathecal space, clonidine has been shown to be an effective analgesic for pain associated with surgery. Spinal clonidine causes a 30% prolongation of sensory and motor block of local anesthetics.1 Intrathecal clonidine appears to have anti-hyperalgesia properties.1 There is evidence to suggest that clonidine intensifies spinal analgesia from bupivacaine, thereby reducing the incidence of tourniquet pain. In addition to providing intraoperative analgesia, there is evidence to suggest that intrathecal clonidine reduces postoperative pain scores.
Conclusion: Based on this integrative review it appears that the use of intrathecal clonidine results in overall increased density and duration of spinal anesthesia and decreased postoperative pain scores. However, additional evidence is necessary in order to develop an exact guideline of intrathecal clonidine dosages to achieve the desired effects. Therefore, the author recommends further research on the use of intrathecal clonidine as an adjuvant to bupivacaine in patients undergoing TKA under spinal anesthesia.
| Type | Other Graduate Paper |
| Acquisition | Proxy-submission |
| Review Type | Faculty Approved: Degree-based Submission |
| Format | Text-based Document |
| Evidence Level | Literature Review |
| Research Approach | Translational Research/Evidence-based Practice |
| Keywords | Intrathecal Clonidine; Total Knee Athroplasty; Mechanism of Action; Tourniquet Pain; Urinary Retention; Pain Reduction; Opioid Consumption |
| Grantor | Bryan College of Health Sciences |
| Advisor | Pecka, Shannon |
| Level | Doctoral-Other |
| Year | 2023 |
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
License
The following license files are associated with this item:
Related items
Showing items related by title, author, creator and subjects.
-
Reiki as a pain management adjunct in the postoperative total knee arthroplasty and surgical obstetric population: An integrative review
Pain is an undesirable, but anticipated component of surgery. Opioids are routinely administered to manage pain for the millions of surgical procedures performed annually in the United States. Given the rising rate of ... -
Anesthetic management in ERAS protocols for total knee and total hip arthroplasty: An integrative review
(2017-07-06)Aims and objectives: The aim of this integrative review is to provide current, evidence-based anesthetic and analgesic recommendations for inclusion in an enhanced recovery after surgery (ERAS) protocol for patients ... -
Perioperative pain management in patients on opioid replacement therapy: An integrative review
(2017-06-26)Despite the lack of compelling evidence to support long-term efficacy in the treatment of opioid abuse, opioids are one of the most common classes of medications prescribed in the United States. As such, the significant ... -
Challenging CAUTI and urinary catheter use reduction in the total hip and knee replacement patient
(2017-10-10)We took a hard look at risk assessment related to indwelling catheter use and potential for CAUTI and the necessity of this practice in the total hip and total knee replacement population in our facility as we do a large ... -
The effect of an esmolol infusion on perioperative opioid use and postoperative pain scores: An integrative review
Objective: The purpose of this integrative review is to investigate the effect of an esmolol infusion on perioperative opioid use and postoperative pain scores. Methods: Articles published between 2012 and 2020 were ...
