Maternal hypotension and efficacy of intrathecal clonidine for cesarean delivery: a retrospective cohort study (2011–2022)
Authors' conclusion
Intrathecal clonidine increases the risk of intraoperative and postoperative hypotension despite the use of prophylactic vasopressors.
Study context
- Population
- Cesarean deliveries with spinal anesthesia at a university hospital in the Netherlands, July 2011–January 2023
- Participants
- 6,103 cesarean deliveries
- Exposure
- Hyperbaric bupivacaine with clonidine vs bupivacaine only vs bupivacaine with lipophilic opioids
- Outcome
- Intraoperative and postoperative hypotension (two primary outcomes)
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Adjusted odds ratio (95% CI)
Bupivacaine with clonidine vs Bupivacaine onlyintraoperative hypotension
1.34(1.15–1.57)
Bupivacaine with clonidine vs Bupivacaine and opioidsintraoperative hypotension; as printed
0.93(0.74–1.18)
Bupivacaine with clonidine vs Bupivacaine onlyhypotension in the recovery room; most frequent with clonidine
3.44(2.89–4.10)
Observational data: associations, not effects.
Secondary outcomes
IV supplementation and conversion to GA
- Less frequent with addition of opioids or clonidine
Other secondary outcomes (neonatal Apgar scores, maternal neurology consultation)
- No relevant differences
Original publication
Maternal hypotension and efficacy of intrathecal clonidine for cesarean delivery: a retrospective cohort study (2011–2022). Int J Obstet Anesth. Published 16 May 2026. doi:10.
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