alpha(2)-adrenergic agonists, mimicking the action of the inhibitory transmitter @entity1063 , cause antinociception due to postsynaptic inhibition of spinothalamic projection neurons, presynaptic inhibition at the central nervous system termination of primary sensory nerves, presynaptic inhibition of brainstem noradrenergic neurons and a generalized decrease in central nervous system sympathetic efferent activity. There is a mutual potentiation of antinociceptive effects of @entity1338 and @entity1286 . @entity1338 is used in @entity1118 states for treatment of @entity1109 and deafferentiating @entity158 . Based on a meta-analysis of the studies published in the years 1996-1996, the therapeutic efficacy of systematically administered @entity1338 was evaluated in @entity1118 states. Out of 403 screened published studies, only 9 fulfilled the selection criteria. Besides three case reports with successful @entity1338 treatment, four placebo-controlled studies could be analyzed treating the following @entity1118 states: chest @entity158 despite normal coronary angiograms; @entity3949 ; @entity14000 ; hyperalgia in @entity1 with sympathetically maintained @entity158 and @entity1643 . Although three studies demonstrated statistically significant improvement in @entity158 scores, the improvement in @entity158 relief in these cases was slight. Long-term treatment was successful in a few responders over a period of 17 months. @entity1931 caused by sympathetically maintained @entity158 was relieved by topical (transdermal) application of @entity1338 . Based on this evaluation a grade C recommendation is derived, which relates to responders. Successful treatment is expected only in @entity158 states with increased sympathetic nervous system activity. Therefore, in @entity1118 , treatment with systemic @entity1338 is of no significant value.

[Alpha 2-adrenergic agonists. Use in XXXX --a meta-analysis].

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1643 :: ('MESH:D017116', 'Disease') :: ['chronic low back pain'] @entity1931 :: ('MESH:D006930', 'Disease') :: ['Hyperalgesia'] @entity1109 :: ('MESH:D012678', 'Disease') :: ['neuropathic, neuralgic'] @entity3949 :: ('MESH:D003929', 'Disease') :: ['painful diabetic neuropathy'] @entity1286 :: ('MESH:D009020', 'Chemical') :: ['morphine'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity1338 :: ('MESH:D003000', 'Chemical') :: ['Clonidine', 'clonidine'] @entity14000 :: ('MESH:D051474', 'Disease') :: ['postherpetic neuralgia'] @entity1063 :: ('MESH:D009638', 'Chemical') :: ['norepinephrine'] @entity1118 :: ('MESH:D059350', 'Disease') :: ['chronic pain']
@entity1118 :: (MESH:D059350,Disease) :: ['chronic pain']
