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Clonidine premedication versus placebo: effects on postoperative agitation and recovery time in children undergoing strabismus surgery.

PURPOSE
Postoperative agitation is common in adults and children following the use of several anesthetics, particularly inhalation anesthetics. This behavior has detrimental effects both physically for the patient following the procedure and psychologically for the parent or guardian. The authors propose that clonidine, an alpha-2 agonist, would provide a reduction in children's postoperative agitation and, in turn, improve parent satisfaction in children undergoing strabismus surgery.


METHODS
Fifty children were prospectively randomized to receive either clonidine or placebo in a double-blind fashion prior to surgery. The children were evaluated using preoperative and postoperative parent questionnaires and postoperative behavioral evaluation using standardized scales including the Pediatric Anesthesia Emergence Delirium and Watcha scales.


RESULTS
Children receiving clonidine immediately after anesthesia induction had statistically significant improvement in postoperative agitation at the 15-minute mark (P = .096) and last score obtained (P = .095) using the Watcha scale. The clonidine group spent an insignificantly longer time in the post-anesthesia care unit (average: 54 minutes) than the placebo group (average 47 minutes) (P = .17). Seventy-one percent of parents reported being "very satisfied" with their child's recovery from anesthesia in the clonidine group compared to 46% in the placebo group, although this was not statistically significant (P = .34).


CONCLUSIONS
Children receiving clonidine prior to undergoing strabismus surgery have a small but noticeable reduction in postoperative agitation, stay slightly longer in the post-anesthesia care unit, and have higher rates of parent satisfaction.