- The largest reported experience with clonidine for regional anaesthesia is with epidural administration.
- Published reports of epidural clonidine have been in the areas of chronic pain, intra- and post-operative pain, and in obstetric and paediatric populations. Chronic cancer and non-cancer pain studies are not examined in this report.
- The use of epidural clonidine as a supplement to general anaesthesia has been the subject of a number studies. Varying doses of clonidine showed a reduction in the utilisation of other agents such as propofol and fentanyl.
- In other studies, the safety and efficacy of epidural clonidine alone or in combination with opioids or local anaesthetics for post-operative analgesia has been examined. Many of the patients studied received either continuous epidural infusions or single or multiple boluses. Epidural clonidine clearly prolonged the analgesic effect and reduced the need for other agents.
- There has been no case of serious haemodynamic or respiratory depression in the epidural administration sample population.
- The addition of clonidine to intrathecal agents such as sufentanil and bupivacaine significantly increases the duration of analgesia with minimal haemodynamic changes.