Clonidine premedication for postoperative analgesia in children

Lambert, Paul C.; Cyna, Allan M; Knight, Nicholas; Middleton, Philippa

doi:10.1002/14651858.cd009633.pub2

Cited by 43 publications

(44 citation statements)

References 53 publications

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“…Clonidine also prolongs the postoperative analgesia. 17,18 In our study, there was significant increase in duration of postoperative analgesia and decreased analgesic requirements in clonidine group compared to placebo group. Studies show that there was no significant change in postanaesthesia discharge time in patients who had received intravenous Clonidine which was analysed using Aldrete score.…”

Section: Discussionsupporting

confidence: 48%

Clonidine Premedication as a Desirable Part of Hypotensive Anaesthesia for Functional Endoscopic Sinus Surgery

Praveen¹,

R²

2016

jemds

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BACKGROUNDClonidine an ideal agent for hypotensive anaesthesia, also attenuates stress response to laryngoscopy, decreases requirement of inhalational anaesthetic agents, decreases postoperative analgesic requirements, prevents post-operative shivering. MATERIAL AND METHODS60 patients under 16-60 years age group posted for functional endoscopic sinus surgery (FESS) were randomly divided into 2 groups of 30 each. Placebo group (Group P) received 20 mL normal saline intravenously and Clonidine group (Group C) received 2.5 micrograms Clonidine per kilogram body weight in 20 mL saline intravenously 20 mins before surgery. Haemodynamic variability during surgery, intraoperative inhalational agent requirement and perioperative bleeding as assessed by surgeon, postoperative analgesic requirement and post-operative shivering were compared between two groups. RESULTSThere was statistically significant reduction in heart rate, systolic blood pressure, diastolic blood pressure and mean blood pressure in Group C compared to Group P. There was statistically significant decrease in requirement of Isoflurane, decreased bleeding from surgical site, decreased analgesic consumption and nil incidence of postoperative shivering in Group C compared to Group P. CONCLUSIONClonidine is an ideal agent for hypotensive anaesthesia as it has got other favourable effects along with controlled hypotension, as it was observed in this study.

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Section: Discussionsupporting

confidence: 48%

Clonidine Premedication as a Desirable Part of Hypotensive Anaesthesia for Functional Endoscopic Sinus Surgery

Praveen¹,

R²

2016

jemds

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“…Clonidine is known to have an analgesic effect. Lambert et al evaluated clonidine premedication for postoperative analgesia in children regardless of the type of surgery. Their results showed that clonidine premedication at 4 µg/kg reduced the relative risk of the need for additional analgesia by 76% compared to a placebo .…”

Section: Discussionmentioning

confidence: 99%

“…Lambert et al evaluated clonidine premedication for postoperative analgesia in children regardless of the type of surgery. Their results showed that clonidine premedication at 4 µg/kg reduced the relative risk of the need for additional analgesia by 76% compared to a placebo . Our results further confirmed the finding that clonidine premedication at 4 µg/kg provided a reduction in the need for additional analgesia by 39% in children undergoing ophthalmic surgery specifically.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous pharmacological treatment strategies, such as dexamethasone, 5‐HT 3 antagonists, dimenhydrinate, droperidol, metoclopramide, and clonidine, may reduce POV. Among these, clonidine, a centrally acting α2‐adrenergic agonist, has useful simultaneous effects in reducing anxiety, providing sedation, antiemesis, and enhancing the pain‐relief effects of other medications . The combination of these qualities in a single medication differentiates clonidine from other treatments for POV.…”

Section: Introductionmentioning

confidence: 99%

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Safety and efficacy of clonidine on postoperative vomiting and pain in pediatric ophthalmic surgery: A systematic review and meta‐analysis

Hsu

Chu

Bai

et al. 2019

Pediatric Anesthesia

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Background Postoperative vomiting and pain are common, unpleasant phenomena in pediatric patients undergoing ophthalmic surgery. Clonidine has antiemetic and analgesic properties and thus may be used as premedication to reduce postoperative vomiting and pain. Aim To assess whether clonidine premedication may safely decrease postoperative vomiting and postoperative pain in pediatric patients who received an ophthalmic surgery. Methods We systematically searched PubMed, EMBASE, Cochrane Library, and Scopus databases from their inception to September 2018. Randomized clinical trials comparing clonidine premedication with a placebo or an active comparator that investigated postoperative vomiting or postoperative pain in pediatric patients undergoing ophthalmic surgery were included. The primary outcome was postoperative vomiting. The secondary outcome was postoperative pain. We also evaluated the safety of clonidine premedication by tracking hemodynamic instability associated with its use. Results Ten studies with 979 patients were eligible for inclusion. Clonidine achieved a significantly lower incidence of postoperative vomiting within 6 hours postoperatively, 6‐24 hours postoperatively, and at the end of the study (risk difference: −0.15; 95% confidence interval: −0.32 to −0.05; risk difference: −0.15; 95% confidence interval: −0.29 to 0.01; and risk difference: −0.23; 95% confidence interval: −0.34 to −0.12, respectively) than placebo. For the subgroup of patients who received strabismus surgery, clonidine produced a lower incidence of postoperative vomiting than placebo (risk difference: −0.19; 95% confidence interval: −0.29 to −0.05). Compared to benzodiazepine, clonidine achieved a lower incidence of postoperative vomiting at the end of the study (risk difference: −0.19; 95% confidence interval: −0.31 to −0.07); the effect was only observed in patients receiving clonidine 4 μg/kg. Furthermore, children receiving clonidine had lower postoperative pain scores, lower analgesic requirements, and more of them were pain‐free compared to those who received a placebo. No patient using clonidine had any major hemodynamic instability. Conclusion Compared to placebo or benzodiazepine, clonidine premedication was effective in reducing postoperative vomiting in pediatric patients undergoing ophthalmic surgery. Clonidine premedication also provided more reduction in postoperative pain when compared to placebo. The use of clonidine premedication was not associated with adverse hemodynamic events.

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“…Clonidine, which is nonirritant as well as odor‐ and tasteless, can be administered by a variety of different routes (oral, nasal, rectal, and intravenous) and is therefore currently used as a valid alternative for pharmacologic premedication in children . Furthermore, clonidine is associated with a number of other desirable effects in the perioperative setting, e.g., reduced dose of induction agent, lower requirements for volatile anesthetics, reduced requirements for peri and postoperative opioids, and reduced incidences of PONV, shivering and emergence agitation . Contrary to other sedative drugs used for pharmacologic premedication in children, clonidine produces sedation that is akin to normal tiredness and sleep and is not associated with mental clouding or amnesia .…”

Section: Introductionmentioning

confidence: 99%

Incidence of bradycardia at arrival to the operating room after oral or intravenous premedication with clonidine in children

Larsson

Eksborg

Lönnqvist

2015

Pediatric Anesthesia

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Clonidine premedication for postoperative analgesia in children

Cited by 43 publications

References 53 publications

Clonidine Premedication as a Desirable Part of Hypotensive Anaesthesia for Functional Endoscopic Sinus Surgery

Clonidine Premedication as a Desirable Part of Hypotensive Anaesthesia for Functional Endoscopic Sinus Surgery

Safety and efficacy of clonidine on postoperative vomiting and pain in pediatric ophthalmic surgery: A systematic review and meta‐analysis

Incidence of bradycardia at arrival to the operating room after oral or intravenous premedication with clonidine in children

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