Alpha-2 agonists in acute pain management.
BACKGROUND
This review explores the significance of alpha-2 agonists used clinically in acute pain management.


METHODS
Although alpha-2 agonists have been reported to have an analgesic effect, they are not commonly used clinically for acute pain management. Clinical studies on use of alpha-2 agonists for acute pain management are reviewed and discussed. A literature search was done using Medline with the keywords 'alpha-2 agonist', 'clonidine', 'dexmedetomidine', 'fadolmidine', 'pharmacokinetics', 'pharmacodynamics', 'postoperative analgesia', 'epidural', 'intrathecal', 'peripheral nerve block' and various combinations with these keywords. The years 1977 - 2009 have been included, with particular focus on clinical studies from between 1990 and 2009.


RESULTS
This article helps to clarify the clinical use of alpha-2 agonists in acute pain management according to current, up-to-date evidence. Clinically, available alpha-2 agonists, including clonidine and dexmedetomidine, are discussed in detail.


CONCLUSIONS
Alpha-2 agonists, especially clonidine, seem to be promising with regard to acute postoperative pain management. However, more clinical evidence on dexmedetomidine is necessary to confirm its definite role in acute postoperative pain control.
Chan
Albert Kam Ming
AK
The Chinese University of Hong Kong, Prince of Wales Hospital, Department of Anaethesia and Intensive Care, Hong Kong.
Cheung
Chi Wai
CW
Chong
Yeow Kuan
YK
D000208:Acute Disease; D058647:Adrenergic alpha-2 Receptor Agonists / Q000494:pharmacology / Q000627:therapeutic use*; D000700:Analgesics / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D010146:Pain / Q000188:drug therapy*
D058647:Adrenergic alpha-2 Receptor Agonists; D000700:Analgesics