• N Tazeroualti, F De Groote, S De Hert, A De Villé, A Dierick, and P Van der Linden.
• Department of Anaesthesia, CHU-Brugmann-HUDERF, 4, Place Van Gehuchten, B-1020 Brussels, and University Hospital Antwerp, Edegem, Belgium.
• Br J Anaesth. 2007 May 1;98(5):667-71.

BackgroundThis randomized, double-blind study tested the hypothesis that, in comparison with midazolam, premedication with oral clonidine reduces the incidence of emergence agitation in preschool children anaesthetized with sevoflurane.MethodsSixty-eight ASA I-II children undergoing circumcision were randomized into three groups to receive different oral premedication given 30 min before anaesthesia: midazolam 0.5 mg kg-1, clonidine 2 microg kg-1, and clonidine 4 microg kg-1. Sevoflurane anaesthesia was administered via a facemask (O2/N2O: 40/60). Analgesia was with penile block (bupivacaine 0.5% 0.3 ml kg-1) and rectal paracetamol (30 mg kg-1). During the first postoperative hour, children were evaluated using a modified 'objective pain scale'.ResultsOnly the 4 microg kg-1 dose of clonidine was associated with a significant reduction in emergence agitation. Fewer children in the clonidine 4 microg kg-1 group displayed agitation (25%) than in the midazolam group (60%) (P=0.025). Incidence of hypotension and bradycardia, time to first micturition and first drink did not differ among groups.ConclusionsIn comparison with midazolam, clonidine 4 microg kg-1 reduced sevoflurane-induced emergence agitation without increasing postoperative side-effects.

This article appears in the collection: Is pre-medication useful in pediatric anesthesia?.

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