Abstract
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.
Sigma Membership
Non-member
Type
Other Graduate Paper
Format Type
Text-based Document
Study Design/Type
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
Advisor
Pecka, Shannon
Degree
Doctoral-Other
Degree Grantor
Bryan College of Health Sciences
Degree Year
2023
Recommended Citation
Maloy, Jennifer, "Clonidine as an adjunct to intrathecal bupivacaine: An integrative review" (2024). Group: Bryan College of Health Sciences Doctor of Nurse Anesthesia Practice (DNAP) Collection. 37.
https://www.sigmarepository.org/group_bryan_dnap/37
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
Rights Holder
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.
Review Type
Faculty Approved: Degree-based Submission
Acquisition
Proxy-submission
Full Text of Presentation
wf_yes
