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Abstract
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Background and Aims Acute postoperative pain is often managed with multimodal pain strategies. Clonidine, due to its analgesic properties, may be a relevant component of this approach. Studies suggest that perioperative use of clonidine reduces postoperative pain intensity and opioid consumption. However, previous studies are limited by small sample sizes and questionable study designs. We hypothesized that a single dose of intraoperatively administered intravenous clonidine would reduce postoperative opioid consumption, pain intensity and opioid-related side effects after spine surgery.
Methods This study is a prospective, randomized, blinded, placebo-controlled trial with two arms. Patients (n = 120) scheduled for spine surgery at Aarhus University Hospital were randomized into two arms: an intervention arm that received a single dose intravenous clonidine (3 micrograms/kg) immediately after intubation, and a control arm that received a placebo containing isotonic saline immediately after intubation. Preoperative opioid-users and non-users were randomized separately to ensure equal representation in the two arms (Figure 1). The primary outcome was opioid consumption (intravenous morphine milligram equivalents) within the first three hours after arrival at the Post-Anesthesia Care Unit.
Results We screened 221 patients out of whom 129 patients were included in the study. In total, 120 patients have completed the study according to the protocol out of whom 31 were preoperative opioid-users and 89 were non-users. Unblinding is anticipated in June 2024 and the final results will be presented at the congress.
Perspectives Our study is expected to provide valuable information on safe and effective multimodal perioperative pain treatment with intraoperative clonidine.
