Skip to main content
SpringerLink
Log in

α-Adrenergic Agonists in Pain Therapy

  • Conference paper
Advances in Pain Therapy II

  • 75 Accesses

Abstract

α-Adrenergic agonists have recently become of interest to pain therapists and anesthesiologists, since drugs of this class exhibit analgesic, sedative, anxiolytic, anesthetic-sparing, and hemodynamic-stabilizing properties. Many details regarding the site and mechanism of action of α2-adrenergic agonists are already known. Before the analgesic actions of α-adrenergic agonists are addressed, their basic and applied pharmacology will be described.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Arnold DE, Coombs DW, Yeager MP, Brinck-Johnson T (1989) Single blind comparison of continuous epidural clonidine, epidural morphine, and parenteral narcotic analgesia upon post abdominal surgery neuroendocrine stress response (cortisol). Anesth Analg 68: S11

    Google Scholar 

  2. Bailey PL, Sperry RJ, Johnson GK, Eldredge SJ, East TD, Pace NL, Stanley TH (1991) Respiratory effects of clonidine alone and combined with morphine in humans. Anesthesiology 74: 43–48

    Article  PubMed  CAS  Google Scholar 

  3. Bernard JM, Hommeril JL, Passuti N, Pinaud M (1991) Postoperative Analgesia by intravenous clonidine. Anesthesiology 75: 577–582

    Article  PubMed  CAS  Google Scholar 

  4. Bonnet F, Boico O, Rostaing S, Saada M, Loriferne JF, Touboul C, Abhay K, Ghinone M (1989) Extradural clonidine analgesia in postoperative patients. Br J Anaesth 63: 465–469

    Article  PubMed  CAS  Google Scholar 

  5. Bonnet F, Diallo A, Saada M, Belon M, Guilbaud M, Boico O (1989) Prevention of tourniquet pain by spinal isobaric bupivacaine with clonidine. Br J Anaesth 63: 93–96

    Article  PubMed  CAS  Google Scholar 

  6. Bonnet F, Boico O, Rostaing S, Loriferne JF, Saada M (1990) Clonidine-induced analgesia in postoperative patients: epidural versus intramuscular administration. Anesthesiology 72: 423–427

    Article  PubMed  CAS  Google Scholar 

  7. Bonnet F, Brun-Buisson V, Frangois Y (1990) Effect of oral and subarachnoid clonidine on spinal anesthesia with bupivacaine. Reg Anesth 15: 211–214

    PubMed  CAS  Google Scholar 

  8. Bylund DB (1988) Subtypes of α2-adrenoceptors: pharmacological and molecular biological evidence converge. Trends Pharmacol Sci 9: 356–361

    Article  PubMed  CAS  Google Scholar 

  9. Carabine UA, Milligan K, Moore J (1992) Extradural clonidine and bupivacaine for postoperative analgesia. Br J Anaesth 68: 132–135

    Article  PubMed  CAS  Google Scholar 

  10. Casey PJ, Gilman AG (1988) G protein involvement in receptor-effector coupling. J Biol Chem 263: 2577–2580

    PubMed  CAS  Google Scholar 

  11. Coombs DW, Saunders RL, LaChange D, Savage S, Ragnarsson TS, Jensen LE (1985) Intrathecal morphine tolerance: use of intrathecal clonidine, DADLE, and intraventricular morphine. Anesthesiology 62: 358–363

    Article  PubMed  CAS  Google Scholar 

  12. Coombs DW, Saunders RL, Fratkin JD, Jensen LE, Murphy CA (1986) Continuous intrathecal hydromorphone and clonidine for intractable cancer pain. J Neurosurg 64: 890–894

    Article  PubMed  CAS  Google Scholar 

  13. Davis KD, Treede RD, Raja SN, Meyer RA, Campell JN (1991) Topical application of clonidine relieves hyperalgesia in patients with sympathetically maintained pain. Pain 47: 309–314

    Article  PubMed  CAS  Google Scholar 

  14. Eisenach JC, Grice SC (1988) Epidural clonidine does not decrease blood pressure or spinal cord blood flow in awake sheep. Anesthesiology 68: 335–340

    Article  PubMed  CAS  Google Scholar 

  15. Eisenach JC, Rauck PL, Buzzanell Ch, Lysak StZ (1989) Epidural clonidine analgesia for intractable cancer pain: phase I. Anesthesiology 71: 647–652

    Article  PubMed  CAS  Google Scholar 

  16. Eisenach JC, Castro MI, Dewan DM, Rose JC (1989) Epidural clonidine analgesia in obstetrics: sheep studies. Anesthesiology 70: 51–56

    Article  PubMed  CAS  Google Scholar 

  17. Eisenach JC, Lysak StZ, Viscomi ChM (1989) Epidural clonidine analgesia following surgery: phase I. Anesthesiology 71: 640–646

    Article  PubMed  CAS  Google Scholar 

  18. Glynn CJ, Teddy PJ, Jamous MA, Moore RA, Lloyd JW (1986) Role of spinal noradrenergic system in transmission of pain in patients with spinal cord injury. Lancet ii: 1249–1250

    Article  Google Scholar 

  19. Glynn C, Dawson D, Samders R (1988) A double-blind comparison between epidural morphine and epidural clonidine in patients with chronic non-cancer pain. Pain 34: 123–128

    Article  PubMed  CAS  Google Scholar 

  20. Glynn CJ, Jamous MA, Teddy PJ (1992) Cerebrospinal fluid kinetics of epidural clonidine in man. Pain 49: 361–367

    Article  PubMed  CAS  Google Scholar 

  21. Gordh Jr T, Tamsen A (1983) A study of the analgetic effect of clonidine in man. Acta Anaesthesiol Scand 27 [Suppl 87]: 72

    Google Scholar 

  22. Gordh T Jr, Feuk U, Norlen K (1986) Effect of epidural clonidine in spinal cord blood flow and regional and central hemodynamics in pigs. Anesth Analg 65: 1312–1318

    PubMed  CAS  Google Scholar 

  23. Gaumann D, Forster A, Griessen M, Habre W, Poinsot O, Della Santa D (1992) Comparison between clonidine and epinephrine admixture to lidocaine in brachial plexus block. Anesth Analg 75: 69–74

    Article  PubMed  CAS  Google Scholar 

  24. Huntoon M, Eisenach JC, Boese P (1992) Epidural clonidine after cesarean section. Appropriate dose and effect of prior local anesthetic. Anesthesiology 76: 187–193

    Article  PubMed  CAS  Google Scholar 

  25. Kauppila T, Kemppainen P, Taanila H, Pertovaara A (1991) Effect of medetomidine, an α2-adrenoceptor agonist on experimental pain in humans. Anesthesiology 74: 3–8

    Article  PubMed  CAS  Google Scholar 

  26. Masata A, Satta G, Alagna S, Anania V, Frassetto GA, Rovasio PP, Semiani A (1985) Effect of clonidine on stress-induced cortisol release in man during surgery. Pharmacol Res Commun 17: 293–298

    Article  Google Scholar 

  27. Mendez R, Eisenach JC, Kashtan K (1990) Epidural clonidine analgesia after cesarean section. Anesthesiology 73: 848–852

    Article  PubMed  CAS  Google Scholar 

  28. Motsch J (1986) Treatment of cancer pain. Schmerz Pain Doleur 7: 68–74

    Google Scholar 

  29. Motsch J, Gräber E, Ludwig K (1990) Addition of clonidine enhances postoperative analgesia from epidural morphine: a double-blind study. Anesthesiology 73: 1067–1073

    Article  PubMed  CAS  Google Scholar 

  30. Mogensen T, Eliasen K, Ejlersen E, Vegger P, Nielsen IK, Kehlet H (1992) Epidural clonidine enhances postoperative analgesia from combined low-dose epidural bupivacaine and morphine regimen. Anesth Analg 75: 607–610

    Article  PubMed  CAS  Google Scholar 

  31. Namiki A, Ujike Y, Takahashi I (1992) Prolongation of tetracaine spinal anesthesia by oral clonidine. Anesth Analg 75: 262–264

    PubMed  Google Scholar 

  32. Post C, Gordh T Jr, Minor BC, Archer T, Freedman J (1987) Antinociceptive effects and spinal cord tissue concentrations after intrathecal injection of guanfacine or clonidine into rats. Anesth Analg 66: 317–324

    Article  PubMed  CAS  Google Scholar 

  33. Racle JP, Benkhadra A, Poy JY (1987) Prolongation of isobaric bupivacaine spinal anesthesia with epinephrine and clonidine for hip surgery in the elderly. Anesth Analg 66: 442–446

    PubMed  CAS  Google Scholar 

  34. Rauck RL et al (1991) Epidural clonidine for refractory reflex sympathetic dystrophy. Anesthesiology 75: A657

    Article  Google Scholar 

  35. Rostaing S, Bonnet F, Levron JC, Vodinh J, Pulskwa F, Saada M (1991) Effect of epidural clonidine in analgesia and pharmacokinetics of epidural fentanyl in postoperative patients. Anesthesiology 75: 420–425

    Article  PubMed  CAS  Google Scholar 

  36. Ruffolo RR Jr (1985) Distribution and function of peripheral α–adrenoceptors on the cardiovascular system. Pharmacol Biochem Behav 22: 827–833

    Article  PubMed  CAS  Google Scholar 

  37. Segal IJ, Jarvis DJ, Duncan SR, White PF, Maze M (1991) Clinical efficacy of transdermal clonidine during the postoperative period. Anesthesiology 74: 220–225

    Article  PubMed  CAS  Google Scholar 

  38. Singelyn FJ, Dangoisse M, Bartholomee S, Gouverneur JM (1992) Adding clonidine to mepivacaine prolongs the duration of anesthesia and analgesia after axillary brachial plexus block. Reg Anesth 17: 148–150

    PubMed  CAS  Google Scholar 

  39. Svenson TH (1987) Stress, central neurotransmitters, and the mechanism of action of alpha-2-adrenoceptor agonists. J Cardiovasc Pharmacol 10 [Suppl 12]: 88–92

    Article  Google Scholar 

  40. Tamsen A, Gordh T Jr (1984) Epidural clonidine produces analgesia. Lancet ii: 231–232

    Google Scholar 

  41. Tryba M, Pern U, Zenz M (1991) Clonidine i.v. is equally effective as morphine i.v. for postoperative analgesia. Anesthesiology 75: A1085

    Article  Google Scholar 

  42. Van Essen EJ, Bovill JG, Ploeger EJ, Beerman H (1988) Intrathecal morphine and clonidine for control of intractable cancer pain. A case report. Acta Anaesthesiol Belg 39: 109–112

    PubMed  Google Scholar 

  43. Van Essen EJ, Bovill JG, Ploeger EJ, Houben JJG (1992) Pharmacokinetics of clonidine after epidural administration in surgical patients. Lack of correlation between plasma concentration and analgesia and blood pressure changes. Acta Anaesthesiol Scand 36: 300–304

    Article  PubMed  Google Scholar 

  44. Vercauteren M, Lauvers E, Meert T, DeHert S, Adriaensen H (1990) Comparison of epidural sufentanil plus clonidine with sufentanil alone for postoperative pain relief. Anaesthesia 45: 534–537

    Article  Google Scholar 

  45. Yaksh TL (1985) Pharmacology of spinal adrenergic systems which modulate spinal nociceptive processing. Pharmacol Biochem Behav 22: 845–858

    Article  PubMed  CAS  Google Scholar 

  46. Yaksh TL, Collins JG (1989) Studies in animals should precede human use of spinally administered drugs. Anesthesiology 70: 4–6

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. J. Motsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. Martin
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Anesthesiology, University of Heidelberg, Im Neuenheimer Feld 110, D-69120, Heidelberg, Germany

    J. Chrubasik M. D. (Professor of Anesthesiology) & E. Martin M. D., F.F.A.R.A.C.S. (Professor of Anesthesiology) (Professor of Anesthesiology) &  (Professor of Anesthesiology)

  2. Department of Anesthesiology, University of Sydney, Royal North Shore Hospital, St. Leonards, NCW 2065, Australia

    M. J. Cousins M. D., F.F.A.R.A.C.S. (Professor of Anaesthesiology) (Professor of Anaesthesiology)

Rights and permissions

Reprints and permissions

Copyright information

© 1993 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Motsch, J., Martin, E. (1993). α-Adrenergic Agonists in Pain Therapy. In: Chrubasik, J., Martin, E., Cousins, M.J. (eds) Advances in Pain Therapy II. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78341-8_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-78341-8_9

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-56917-6

  • Online ISBN: 978-3-642-78341-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation