{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T07:09:09Z","timestamp":1793257749988,"version":"4.5.0"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Anesthesiology"],"published-print":{"date-parts":[[2009,8,1]]},"abstract":"<jats:p>The effect of adding clonidine to local anesthetics for nerve or plexus blocks remains unclear. The authors searched for randomized placebo-controlled trials testing the impact of adding clonidine to local anesthetics for peripheral single-injection nerve or plexus blocks in adults undergoing any surgery (except eye) without general anesthesia. Twenty trials (1,054 patients, 573 received clonidine) published 1992-2006 tested plexus (14 brachial, 1 cervical) and nerve blocks (2 sciatic\/femoral, 1 midhumeral, 1 ilioinguinal\/iliohypogastric, 1 ankle). Clonidine doses ranged from 30 to 300 microg; most patients received 150 microg. Clonidine prolonged the duration of postoperative analgesia (weighted mean difference 122 min; 95% confidence interval [CI] 74-169), sensory block (weighted mean difference 74 min; 95% CI 37-111), and motor block (weighted mean difference 141 min; 95% CI 82-199). In a subgroup of patients receiving an axillary plexus block, these effects were independent of whether clonidine was added to an intermediate or a long-acting local anesthetic. Clonidine increased the risk of arterial hypotension (odds ratio 3.61; 95% CI 1.52-8.55; number-needed-to-harm 11), orthostatic hypotension or fainting (odds ratio 5.07; 95% CI 1.20-21.4; number-needed-to-harm 10), bradycardia (odds ratio 3.09; 95% CI 1.10-8.64; number-needed-to-harm 13), and sedation (odds ratio 2.28; 95% CI 1.15-4.51; number-needed-to-harm 5). There was a lack of evidence of dose-responsiveness for beneficial or harmful effects. Clonidine added to intermediate or long-acting local anesthetics for single-shot peripheral nerve or plexus blocks prolongs duration of analgesia and motor block by about 2 h. The increased risk of hypotension, fainting, and sedation may limit its usefulness. Dose-responsiveness remains unclear.<\/jats:p>","DOI":"10.1097\/aln.0b013e3181aae897","type":"journal-article","created":{"date-parts":[[2009,7,16]],"date-time":"2009-07-16T03:24:09Z","timestamp":1247714649000},"page":"406-415","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":296,"title":["Clonidine as an Adjuvant to Local Anesthetics for Peripheral Nerve and Plexus Blocks"],"prefix":"10.1097","volume":"111","author":[{"given":"Daniel\u00a0M.","family":"P\u00f6pping","sequence":"first","affiliation":[{"name":"Anesthesiologist, Department of Anesthesiology and Intensive Care, University Hospital M\u00fcnster, M\u00fcnster, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Elia","sequence":"additional","affiliation":[{"name":"Research Associate, Division of Anesthesiology, University Hospitals of Geneva, and Faculty of Medicine, University of Geneva, Geneva, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Marret","sequence":"additional","affiliation":[{"name":"Consultant Anesthetist, Division of Anesthesiology, University Hospitals of Geneva, Geneva, Switzerland, and Department of Anesthesia and Intensive Care, Tenon University Hospital, Assistance Publique H\u00f4pitaux de Paris, Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Wenk","sequence":"additional","affiliation":[{"name":"Anesthesiologist, Department of Anesthesiology and Intensive Care, University Hospital M\u00fcnster, M\u00fcnster, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin\u00a0R.","family":"Tram\u00e8r","sequence":"additional","affiliation":[{"name":"Professor of Anesthesiology, Division of Anesthesiology, University Hospitals of Geneva, and Faculty of Medicine, University of Geneva."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David\u00a0S.","family":"Warner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark\u00a0A.","family":"Warner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-28-20251013"},{"key":"R2-28-20251013"},{"key":"R3-28-20251013"},{"key":"R4-28-20251013"},{"key":"R5-28-20251013"},{"key":"R6-28-20251013"},{"key":"R7-28-20251013"},{"key":"R8-28-20251013"},{"key":"R9-28-20251013"},{"key":"R10-28-20251013"},{"key":"R11-28-20251013"},{"key":"R12-28-20251013"},{"key":"R13-28-20251013"},{"key":"R14-28-20251013"},{"key":"R15-28-20251013"},{"key":"R16-28-20251013"},{"key":"R17-28-20251013"},{"key":"R18-28-20251013"},{"key":"R19-28-20251013"},{"key":"R20-28-20251013"},{"key":"R21-28-20251013"},{"key":"R22-28-20251013"},{"key":"R23-28-20251013"},{"key":"R24-28-20251013"},{"key":"R25-28-20251013"},{"key":"R26-28-20251013"},{"key":"R27-28-20251013"},{"key":"R28-28-20251013"},{"key":"R29-28-20251013"},{"key":"R30-28-20251013"},{"key":"R31-28-20251013"},{"key":"R32-28-20251013"},{"key":"R33-28-20251013"},{"key":"R34-28-20251013"},{"key":"R35-28-20251013"},{"key":"R36-28-20251013"},{"key":"R37-28-20251013"},{"key":"R38-28-20251013"},{"key":"R39-28-20251013"},{"key":"R40-28-20251013"}],"container-title":["Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/pubs.asahq.org\/anesthesiology\/article-pdf\/111\/2\/406\/246401\/0000542-200908000-00028.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.lww.com\/00000542-200908000-00027","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T16:16:23Z","timestamp":1760372183000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00000542-200908000-00027"}},"subtitle":["A Meta-analysis of Randomized Trials"],"short-title":[],"issued":{"date-parts":[[2009,8,1]]},"references-count":40,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2009]]}},"URL":"https:\/\/doi.org\/10.1097\/aln.0b013e3181aae897","relation":{},"ISSN":["0003-3022"],"issn-type":[{"value":"0003-3022","type":"print"}],"subject":[],"published":{"date-parts":[[2009,8,1]]}}}