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Clonidine: an alternative to benzodiazepines for premedication in children

Henrik Bergendahl1, Per-Arne Lönnqvist, Staffan Eksborg

  • 1Department of Anaesthesia, Intensive, and Pain Care, Karolinska University Hospital, Huddinge, Sweden. henrik.bergendahl@karolinska.se

Current Opinion in Anaesthesiology
|March 15, 2006
PubMed

Insights

Clonidine offers a favorable alternative to midazolam for pediatric premedication, showing fewer adverse effects on cognition and behavior. This review summarizes its use and compares it with benzodiazepines.

Area of Science:

  • Anesthesiology
  • Pediatric Pharmacology

Background:

  • Midazolam is the most common pediatric premedication, but it has significant drawbacks.
  • Limited trials validate midazolam's efficacy and safety.
  • Clonidine use in pediatric premedication is increasing.

Purpose of the Study:

  • To review clonidine's use in pediatric premedication.
  • To compare clonidine with benzodiazepines for this indication.
  • To present a clonidine premedication protocol.

Main Methods:

  • Literature review of clonidine and benzodiazepine use in pediatric premedication.
  • Summary of published trials comparing clonidine and benzodiazepines.
  • Analysis of perioperative effects and adverse events.

Main Results:

  • Clonidine enhances perioperative management in children with mild circulatory effects.
  • Clonidine is associated with fewer adverse effects than midazolam.
  • Trials comparing clonidine and midazolam are limited but growing.

Conclusions:

  • Clonidine is a viable alternative to midazolam, lacking its negative effects on cognition and behavior.
  • Clonidine offers beneficial perioperative effects.
  • Clinical experience replacing midazolam with clonidine in children has been positive.
Abstract

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