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Intrathecal Clonidine as an Adjuvant for Neuraxial Anaesthesia During Cesarean Delivery: A Systematic Review and Meta-Analysis of Randomized Trials

Crespo, S.; Dangelser, G.; Haller, G.

doi: 10.1097/01.aoa.0000542385.03094.2e
Anesthesia and Analgesia: Regional Anesthesia

(Int J Obstet Anesth 2017;32:64–76)

Several adjuvants are commonly used with spinal anesthesia, including fentanyl, sufentanil, morphine, epinephrine, and clonidine, in an attempt to decrease the required dose of local anesthetic. While the benefits of intrathecal clonidine administration for acute and postoperative pain control have been confirmed by various studies, there is limited knowledge about any potential harmful effects. Just one systematic review has been published addressing the risk-benefit ratio of spinal clonidine, and that review included only one obstetric study. In fact, regulatory agencies in several countries, including the US Food and Drug Administration, have not yet approved clonidine for intrathecal use so it is currently being used “off-label.” This current systematic review and meta-analysis aimed to identify the risks and benefits associated with intrathecal clonidine used as an adjuvant to spinal local anesthesia for cesarean delivery.

Department of Anaesthesia, Pharmacology & Intensive Care, Geneva University Hospital, Switzerland

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