Systematically administered opioids activate bulbospinal noradrenergic pathways. The resulting spinally released norepinephrine activates a2-adrenoceptors on cholinergic neurons, causing ACh release and inhibition of spinal transmission of noxious sensory information. This study tests a computer-based methodology for administering clonidine epidurally to potentiate analgesia from intraspinal a-adrenergic agonist and from systemic opioids.
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