{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T18:27:18Z","timestamp":1782584838606,"version":"3.54.5"},"reference-count":52,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2017,11,1]],"date-time":"2017-11-01T00:00:00Z","timestamp":1509494400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2017,11,1]],"date-time":"2017-11-01T00:00:00Z","timestamp":1509494400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2017,11,1]],"date-time":"2017-11-01T00:00:00Z","timestamp":1509494400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2017,11,1]],"date-time":"2017-11-01T00:00:00Z","timestamp":1509494400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2017,11,1]],"date-time":"2017-11-01T00:00:00Z","timestamp":1509494400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2017,11,1]],"date-time":"2017-11-01T00:00:00Z","timestamp":1509494400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2017,11,1]],"date-time":"2017-11-01T00:00:00Z","timestamp":1509494400000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","obstetanesthesia.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Obstetric Anesthesia"],"published-print":{"date-parts":[[2017,11]]},"DOI":"10.1016\/j.ijoa.2017.06.009","type":"journal-article","created":{"date-parts":[[2017,6,27]],"date-time":"2017-06-27T03:46:47Z","timestamp":1498535207000},"page":"64-76","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":44,"special_numbering":"C","title":["Intrathecal clonidine as an adjuvant for neuraxial anaesthesia during caesarean delivery: a systematic review and meta-analysis of randomised trials"],"prefix":"10.1016","volume":"32","author":[{"given":"S","family":"Crespo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Dangelser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Haller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"331","key":"10.1016\/j.ijoa.2017.06.009_b0005","first-page":"e1","article-title":"Inequities in the use of cesarean section deliveries in the world","volume":"206","author":"Gibbons","year":"2012","journal-title":"Am J Obstet Gynecol"},{"key":"10.1016\/j.ijoa.2017.06.009_b0010","unstructured":"Gibbons L. The global numbers and costs of additionally needed and unnecessary caesarean sections performed per year: Overuse as a barrier to universal coverage. World Health Report 2010; Background Paper, 30."},{"key":"10.1016\/j.ijoa.2017.06.009_b0015","first-page":"1","article-title":"Topics in spinal anaesthesia","volume":"1","author":"Whizar Lugo","year":"2014","journal-title":"J Anesth Crit Care"},{"key":"10.1016\/j.ijoa.2017.06.009_b0020","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1213\/00000539-198209000-00005","article-title":"Reduction in halothane anesthetic requirement by clonidine, an alpha-adrenergic agonist","volume":"61","author":"Bloor","year":"1982","journal-title":"Anesth Analg"},{"key":"10.1016\/j.ijoa.2017.06.009_b0025","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1097\/00000542-198106000-00004","article-title":"Studies in the primate on the analgetic effects associated with intrathecal actions of opiates, alpha-adrenergic agonists and baclofen","volume":"54","author":"Yaksh","year":"1981","journal-title":"Anesthesiology"},{"key":"10.1016\/j.ijoa.2017.06.009_b0030","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1097\/00000542-198909000-00018","article-title":"Pharmacokinetics and dynamics of intravenous, intrathecal, and epidural clonidine in sheep","volume":"71","author":"Castro","year":"1989","journal-title":"Anesthesiology"},{"key":"10.1016\/j.ijoa.2017.06.009_b0035","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.pharmthera.2007.09.003","article-title":"Modulation of pain transmission by G-protein-coupled receptors","volume":"117","author":"Pan","year":"2008","journal-title":"Pharmacol Ther"},{"key":"10.1016\/j.ijoa.2017.06.009_b0040","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1097\/00000542-199302000-00011","article-title":"Hemodynamic and analgesic actions of epidurally administered clonidine","volume":"78","author":"Eisenach","year":"1993","journal-title":"Anesthesiology"},{"key":"10.1016\/j.ijoa.2017.06.009_b0045","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/0304-3959(94)00209-W","article-title":"Epidural clonidine analgesia for intractable cancer pain. The Epidural Clonidine Study Group","volume":"61","author":"Eisenach","year":"1995","journal-title":"Pain"},{"key":"10.1016\/j.ijoa.2017.06.009_b0050","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1213\/00000539-199408000-00014","article-title":"An isobolographic study of epidural clonidine and fentanyl after cesarean section","volume":"79","author":"Eisenach","year":"1994","journal-title":"Anesth Analg"},{"key":"10.1016\/j.ijoa.2017.06.009_b0055","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1097\/00000542-199004000-00015","article-title":"Intrathecal clonidine in obstetrics: sheep studies","volume":"72","author":"Eisenach","year":"1990","journal-title":"Anesthesiology"},{"key":"10.1016\/j.ijoa.2017.06.009_b0060","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1097\/00000539-200012000-00037","article-title":"The efficacy of intrathecal morphine and clonidine in the treatment of pain after spinal cord injury","volume":"91","author":"Siddall","year":"2000","journal-title":"Anesth Analg"},{"key":"10.1016\/j.ijoa.2017.06.009_b0065","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1097\/00000542-199409000-00011","article-title":"Hemodynamic and analgesic profile after intrathecal clonidine in humans. A dose-response study","volume":"81","author":"Filos","year":"1994","journal-title":"Anesthesiology"},{"key":"10.1016\/j.ijoa.2017.06.009_b0070","first-page":"15","article-title":"Comparison of clonidine and fentanyl as an adjuvant to intrathecal bupivacaine for spinal anaesthesia and postoperative analgesia in patients undergoing caesarian section","volume":"22","author":"Vinayak","year":"2014","journal-title":"Sri Lankan J Anesthesiol"},{"key":"10.1016\/j.ijoa.2017.06.009_b0075","doi-asserted-by":"crossref","first-page":"1460","DOI":"10.1213\/01.ANE.0000111208.08867.3C","article-title":"Postcesarean analgesia with spinal morphine, clonidine, or their combination","volume":"98","author":"Paech","year":"2004","journal-title":"Anesth Analg"},{"key":"10.1016\/j.ijoa.2017.06.009_b0080","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1097\/00000539-200211000-00054","article-title":"A randomized, double-blinded trial of subarachnoid bupivacaine and fentanyl, with or without clonidine, for combined spinal\/epidural analgesia during labor","volume":"95","author":"Paech","year":"2002","journal-title":"Anesth Analg"},{"key":"10.1016\/j.ijoa.2017.06.009_b0085","doi-asserted-by":"crossref","first-page":"31","DOI":"10.4103\/1658-354X.76499","article-title":"Evaluation of analgesic effects of intrathecal clonidine along with bupivacaine in cesarean section","volume":"5","author":"Kothari","year":"2011","journal-title":"Saudi J Anaesth"},{"key":"10.1016\/j.ijoa.2017.06.009_b0090","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1136\/rapm-00115550-199823010-00010","article-title":"Enhancement of analgesic effect of intrathecal neostigmine and clonidine on bupivacaine spinal anesthesia","volume":"23","author":"Pan","year":"1998","journal-title":"Reg Anesth Pain Med"},{"key":"10.1016\/j.ijoa.2017.06.009_b0095","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1213\/ane.0b013e31817f1595","article-title":"An evaluation of the postoperative antihyperalgesic and analgesic effects of intrathecal clonidine administered during elective cesarean delivery","volume":"107","author":"Lavand'homme","year":"2008","journal-title":"Anesth Analg"},{"key":"10.1016\/j.ijoa.2017.06.009_b0100","doi-asserted-by":"crossref","first-page":"283","DOI":"10.4103\/1658-354X.115360","article-title":"The effect of addition of intrathecal clonidine to hyperbaric bupivacaine on postoperative pain after lower segment caesarean section: a randomized control trial","volume":"7","author":"Singh","year":"2013","journal-title":"Saudi J Anaesth"},{"key":"10.1016\/j.ijoa.2017.06.009_b0105","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1136\/rapm-00115550-200803000-00011","article-title":"Clonidine as an adjuvant to intrathecal local anesthetics for surgery: systematic review of randomized trials","volume":"33","author":"Elia","year":"2008","journal-title":"Reg Anesth Pain Med"},{"key":"10.1016\/j.ijoa.2017.06.009_b0110","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1002\/cpt.320","article-title":"The FDA's sentinel initiative\u2013A comprehensive approach to medical product surveillance","volume":"99","author":"Ball","year":"2016","journal-title":"Clin Pharmacol Ther"},{"issue":"264\u20139","key":"10.1016\/j.ijoa.2017.06.009_b0115","first-page":"W64","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"151","author":"Moher","year":"2009","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.ijoa.2017.06.009_b0120","doi-asserted-by":"crossref","first-page":"851","DOI":"10.2165\/00002018-200528100-00003","article-title":"Clarification of terminology in drug safety","volume":"28","author":"Aronson","year":"2005","journal-title":"Drug Saf"},{"key":"10.1016\/j.ijoa.2017.06.009_b0125","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1067\/mpd.2001.114694","article-title":"The association of Apgar score with subsequent death and cerebral palsy: a population-based study in term infants","volume":"138","author":"Moster","year":"2001","journal-title":"J Pediatr"},{"key":"10.1016\/j.ijoa.2017.06.009_b0130","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1056\/NEJM200102153440701","article-title":"The continuing value of the Apgar score for the assessment of newborn infants","volume":"344","author":"Casey","year":"2001","journal-title":"N Engl J Med"},{"key":"10.1016\/j.ijoa.2017.06.009_b0135","first-page":"65","article-title":"Low 5-minute Apgar score: a population-based register study of 1 million term births","volume":"98","author":"Thorngren-Jerneck","year":"2001","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.ijoa.2017.06.009_b0140","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1213\/00000539-199809000-00022","article-title":"Intrathecal clonidine and fentanyl with hyperbaric bupivacaine improves analgesia during cesarean section","volume":"87","author":"Benhamou","year":"1998","journal-title":"Anesth Analg"},{"key":"10.1016\/j.ijoa.2017.06.009_b0145","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1093\/bja\/ael182","article-title":"The effect of addition of intrathecal clonidine to hyperbaric bupivacaine on postoperative pain and morphine requirements after Caesarean section: a randomized controlled trial","volume":"97","author":"van Tuijl","year":"2006","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.ijoa.2017.06.009_b0150","first-page":"581","article-title":"A randomised controlled trial to evaluate the effectiveness of intrathecal bupivacaine combined with different adjuvants (fentanyl, clonidine and dexmedetomidine) in caesarean section","volume":"65","author":"Li","year":"2015","journal-title":"Drug Res (Stuttg)"},{"key":"10.1016\/j.ijoa.2017.06.009_b0155","doi-asserted-by":"crossref","first-page":"d5928","DOI":"10.1136\/bmj.d5928","article-title":"The Cochrane Collaboration\u2019s tool for assessing risk of bias in randomised trials","volume":"343","author":"Higgins","year":"2011","journal-title":"BMJ"},{"key":"10.1016\/j.ijoa.2017.06.009_b0160","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1016\/S0034-7094(12)70178-2","article-title":"Spinal anesthesia for cesarean section. Use of hyperbaric bupivacaine (10mg) combined with different adjuvants","volume":"62","author":"Braga","year":"2012","journal-title":"Rev Bras Anestesiol"},{"key":"10.1016\/j.ijoa.2017.06.009_b0165","doi-asserted-by":"crossref","first-page":"63","DOI":"10.4103\/2229-5151.97269","article-title":"Prevention of hypotension and prolongation of postoperative analgesia in emergency cesarean sections: a randomized study with intrathecal clonidine","volume":"2","author":"Bajwa","year":"2012","journal-title":"Int J Crit Illn Inj Sci"},{"key":"10.1016\/j.ijoa.2017.06.009_b0170","first-page":"370","article-title":"Postoperative analgesia for cesarean section. Does the addition of clonidine to subarachnoid morphine improve the quality of the analgesia?","volume":"56","author":"Das Neves","year":"2006","journal-title":"Rev Bras Anestesiol"},{"key":"10.1016\/j.ijoa.2017.06.009_b0175","first-page":"513628","article-title":"Comparison of postoperative analgesic effect of intrathecal clonidine and fentanyl added to bupivacaine in patients undergoing cesarean section: a prospective randomized double-blind study","volume":"2014","author":"Khezri","year":"2014","journal-title":"Pain Res Treat"},{"key":"10.1016\/j.ijoa.2017.06.009_b0180","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1016\/S0034-7094(12)70178-2","article-title":"Spinal anesthesia for cesarean section. Use of hyperbaric bupivacaine (10mg) combined with different adjuvants","volume":"62","author":"Braga","year":"2012","journal-title":"Rev Bras Anestesiol"},{"key":"10.1016\/j.ijoa.2017.06.009_b0190","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1034\/j.1399-6576.1999.430512.x","article-title":"Enhancement of intrathecal lidocaine by addition of local and systemic clonidine","volume":"43","author":"Dobrydnjov","year":"1999","journal-title":"Acta Anaesthesiol Scand"},{"key":"10.1016\/j.ijoa.2017.06.009_b0195","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1213\/00000539-199205000-00017","article-title":"Clonidine enhances the effects of lidocaine on C-fiber action potential","volume":"74","author":"Gaumann","year":"1992","journal-title":"Anesth Analg"},{"key":"10.1016\/j.ijoa.2017.06.009_b0200","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0014-2999(99)00620-2","article-title":"Mechanism of antinociceptive action of clonidine in nonmyelinated nerve fibres","volume":"383","author":"Erne-Brand","year":"1999","journal-title":"Eur J Pharmacol"},{"key":"10.1016\/j.ijoa.2017.06.009_b0205","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1097\/00000542-199012000-00022","article-title":"Antinociceptive interaction between opioids and medetomidine: systemic additivity and spinal synergy","volume":"73","author":"Ossipov","year":"1990","journal-title":"Anesthesiology"},{"key":"10.1016\/j.ijoa.2017.06.009_b0210","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1213\/00000539-199103000-00008","article-title":"Low-dose clonidine enhances pregnancy-induced analgesia to visceral but not somatic stimuli in rats","volume":"72","author":"Iwasaki","year":"1991","journal-title":"Anesth Analg"},{"key":"10.1016\/j.ijoa.2017.06.009_b0215","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1097\/00000542-199609000-00026","article-title":"Alpha(2)-adrenergic agonists for regional anesthesia. A clinical review of clonidine (1984\u20131995)","volume":"85","author":"Eisenach","year":"1996","journal-title":"Anesthesiology"},{"key":"10.1016\/j.ijoa.2017.06.009_b0220","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.ijoa.2013.11.006","article-title":"Enhanced recovery from obstetric surgery: a U.K. survey of practice","volume":"23","author":"Aluri","year":"2014","journal-title":"Int J Obstet Anesth"},{"key":"10.1016\/j.ijoa.2017.06.009_b0225","doi-asserted-by":"crossref","first-page":"254","DOI":"10.2174\/157015908785777193","article-title":"Functional neuroanatomy of the noradrenergic locus coeruleus: its roles in the regulation of arousal and autonomic function part II: physiological and pharmacological manipulations and pathological alterations of locus coeruleus activity in humans","volume":"6","author":"Samuels","year":"2008","journal-title":"Curr Neuropharmacol"},{"key":"10.1016\/j.ijoa.2017.06.009_b0230","first-page":"396","article-title":"\u03912-agonistas em anestesiologia: aspectos cl\u00ednicos e farmacol\u00f3gicos","volume":"50","author":"Alves","year":"2000","journal-title":"Rev Bras Anestesiol"},{"key":"10.1016\/j.ijoa.2017.06.009_b0235","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1097\/00000542-199908000-00012","article-title":"Analgesic and hemodynamic effects of intrathecal clonidine as the sole analgesic agent during first stage of labor: a dose-response study","volume":"91","author":"Chiari","year":"1999","journal-title":"Anesthesiology"},{"key":"10.1016\/j.ijoa.2017.06.009_b0240","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1213\/01.ANE.0000133580.54026.65","article-title":"Small-dose intrathecal clonidine and isobaric bupivacaine for orthopedic surgery: a dose-response study","volume":"99","author":"Strebel","year":"2004","journal-title":"Anesth Analg"},{"key":"10.1016\/j.ijoa.2017.06.009_b0245","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1523\/JNEUROSCI.01-08-00908.1981","article-title":"Inhibition of sympathetic preganglionic neurons by catecholamines and clonidine: mediation by an alpha-adrenergic receptor","volume":"1","author":"Guyenet","year":"1981","journal-title":"J Neurosci"},{"key":"10.1016\/j.ijoa.2017.06.009_b0250","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1054\/ijoa.1999.0348","article-title":"Effect of injection rate on hypotension associated with spinal anesthesia for cesarean section","volume":"9","author":"Simon","year":"2000","journal-title":"Int J Obstet Anesth"},{"key":"10.1016\/j.ijoa.2017.06.009_b0255","doi-asserted-by":"crossref","first-page":"31","DOI":"10.4103\/0970-9185.76613","article-title":"Table tilt versus pelvic tilt position for intrauterine resuscitation during spinal anaesthesia for caesarian section","volume":"27","author":"Haleem","year":"2011","journal-title":"J Anaesthesiol Clin Pharmacol"},{"key":"10.1016\/j.ijoa.2017.06.009_b0260","first-page":"CD002251","article-title":"Techniques for preventing hypotension during spinal anaesthesia for caesarean section","author":"Cyna","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"key":"10.1016\/j.ijoa.2017.06.009_b0265","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S0959-289X(02)80032-2","article-title":"Effect of intrathecal clonidine anaesthesia on intraoperative outcomes during caesarean section","volume":"11","author":"Haines","year":"2002","journal-title":"Int J Obstet Anesth"}],"container-title":["International Journal of Obstetric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0959289X16301728?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0959289X16301728?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T07:50:59Z","timestamp":1766994659000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0959289X16301728"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11]]},"references-count":52,"alternative-id":["S0959289X16301728"],"URL":"https:\/\/doi.org\/10.1016\/j.ijoa.2017.06.009","relation":{},"ISSN":["0959-289X"],"issn-type":[{"value":"0959-289X","type":"print"}],"subject":[],"published":{"date-parts":[[2017,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Intrathecal clonidine as an adjuvant for neuraxial anaesthesia during caesarean delivery: a systematic review and meta-analysis of randomised trials","name":"articletitle","label":"Article Title"},{"value":"International Journal of Obstetric Anesthesia","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ijoa.2017.06.009","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2017 Elsevier Ltd. All rights reserved.","name":"copyright","label":"Copyright"}]}}