Pain Management Table 29 Clonidine for Treatment of SCI Pain

Author Year

Country

PEDro Score

Research Design

Total Sample Size

Methods Outcome

Siddall et al. 2000

Australia

RCT

PEDro=8

N=15

Population: Age=26-78 yr; Type of pain=neuropathic: 13 had below level neuropathic pain, 4 at level of neuropathic pain, 3 had both neuropathic and nociceptive pain.

Intervention: Placebo, morphine or Clonidine was delivered via catheter into lumbar intrathecal space. The subjects were first given either: 2, 1 mg morphine, 50-100 mcg of Clonidine or placebo. Dosage was increased if the subject had no side effects and no pain relief. Subjects could receive up to 1.5 times the initial drug dosage if necessary. Once the subject received satisfactory pain relief or side effects from the drug they were on they were given a mixture of morphine and Clonidine.

Outcome Measures: Numerical pain rating scale, numerical pain relief score, a verbal pain rating and a nausea scale and sedation scores were recorded.

1.     The administration of morphine or clonidine resulted in a mean reduction in pain levels but this was not statistically significant compared to the effect of placebo.

2.     When the mixture of morphine and clonidine was administered there was a significant reduction in pain when compared to those on placebo (p=0.0084).

Uhle et al. 2000 Germany

PCT

N=10

Population: Age=34-77 yr; Gender males=4, females=6; Time since injury=1-10 yr; Type of pain=neuropathic.

Intervention: Subjects, once implanted with a medical pump, were originally given 3 mL of saline followed by 1 mL of morphine, this was followed by a second dose of morphine (0.02 mg) provided no side effects or benefits were noted. This was followed by Clonidine (30 ug in 1 mL) and then depending on side effects a final dose of Clonidine (50 ug in 1 mL). After each drug administration the catheter was flushed with saline.

Outcomes Measures: Not specified.

1.     Subjects reported a good to excellent pain reduction following the administration of Clonidine administration.

2.     After Clonidine bolus subjects experienced an optimum pain reduction. Average dose of Clonidine was initially 53 ug/day and this decreased (or stabilized) to 44 ug/day.

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