The use of intrapleural clonidine for postoperative pain control

While the potent analgesic properties of clonidine, a centrally-acting antihypertensive agent, in humans is well described, its analgesic effect when administered into the pleural cavity is largely unknown. We have used intrapleural clonidine as a primary analgesic agent for postoperative pain control in two patients who had undergone cholecystectomy. Clonidine was instilled into the pleural space at the end of the operation via a silastic catheter placed through the seventh intercostal space. Oral pain medications were resumed within 48 hours after removal of the intrapleural catheter. In both patients, there was a substantial improvement in pulmonary function correlating with adequate pain control. No complications were noted secondary to the use of intrapleural clonidine. We conclude that intrapleurally administered clonidine is sufficient to provide adequate postoperative analgesia following abdominal surgery.