Peri-op Clonidine: Benefits Not There, But Hypotension Is

Anesthesiologists who use perioperative clonidine in the hope of reducing acute postoperative pain or opioid consumption need to reconsider their efforts.

According to a randomized controlled trial at the Cleveland Clinic, in Ohio—the largest such trial ever—researchers found that the drug has neither of these perceived benefits, and its use may come at the expense of hypotension.

“Anesthesiologists have been using clonidine for sedation and analgesia for years, even though it’s primarily a blood pressure medication,” said Alparslan Turan, MD, professor of anesthesiology and vice chair of the Department of Outcomes Research at the Cleveland Clinic. “However, the only place where it’s been proven to work is in epidural and caudal analgesia. Oral and transdermal use have not been tested in large trials, and the data in the literature is not that solid.”

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