The clinical Evaluation of the Epidurally Administered Clonidine for the Pain Control of the Patients with Buerger's Disease

Ryu, Keon Hee; Kil, Hyeon Ja; Suh, Jae Hyun; Kim, Sung Nyeun

Abstract

Buerger's disease (Thromboangiitis Obliterans) is characterized by peripheral arterial occlusion of the extremities in young smokers, and leading to ischemia of the tissue and gangrene. Most of these patients suffered from severe pain. Therapy for Buergers disease not enable to undergo reconstructive arterial surgery has been discouraging while multiple modes of analgesics have advanced. Eight subjects who had been operated due to Buerger's disease or diagnosed with this disease were evaluated retrospectively. Continuous epidural block was done at L 2-3 or L3-4 intervertebral space and multiday continuous infusor was connected to epidural catheter. The content of the infusor was clonidine-bupivacaine or clonidine-morphine-bupivacaine mixture. The minimum dose of clonidine was 75 microgram/day and the maximum 450vicrogramg/day. The results were as follows: 1) The analgesia produced by clonidine was superior to any other analgesics. 2) The incidence of the side effects produced by clonidine-bupivacaine mixture were less than that of clonidine-morphine-bupivacaine mixture. 3) Minimum dose of clonidine for the pain relief was required more than 225 microgram per day. From the above results, we recommend that clonidine is an effective agent to provide pain relief for the patients with Buerger's disease.