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Comparative study of oral clonidine and diazepam as premedicants in children
V J Ramesh1, N Bhardwaj, Y K Batra
1Department of Anaesthesia, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Insights
Clonidine effectively sedates pediatric patients comparable to diazepam before anesthesia. It also reduces the hemodynamic response to intubation without causing significant complications or delaying recovery.
Area of Science:
- Anesthesiology
- Pediatric Anesthesia
- Pharmacology
Background:
- Pre-anesthetic medication is crucial for managing pediatric patients.
- Sedation and blunting the intubation response are key goals.
- Diazepam is a commonly used pre-anesthetic agent.
Purpose of the Study:
- To compare the efficacy of oral clonidine versus diazepam as a pre-anesthetic medication in children.
- To assess sedation levels, hemodynamic response to intubation, and recovery times.
Main Methods:
- Prospective, double-blind, controlled study involving 50 children (4-12 years).
- Group I received oral diazepam (0.2 mg/kg); Group II received oral clonidine (3 µg/kg) 90-120 minutes before anesthesia induction.
- Evaluated sedation, hemodynamic changes during laryngoscopy/intubation, and recovery.
Main Results:
- Clonidine (3 µg/kg) provided sedation comparable to diazepam (0.2 mg/kg) (p > 0.1).
- Clonidine significantly attenuated hemodynamic responses to intubation (p > 0.01).
- Recovery was not delayed with clonidine (p < 0.01); no significant hypotension or bradycardia observed.
Conclusions:
- Oral clonidine (3 µg/kg) is an effective pre-anesthetic agent in children.
- It offers comparable sedation to diazepam while mitigating intubation-related hemodynamic stress.
- Clonidine presents a safe alternative, without increased complications or delayed recovery.
Abstract:
In a prospective, double-blind, controlled study the efficacy of clonidine was assessed in children, with respect to sedation, intubation response, and recovery. Fifty children, aged 4-12 years, undergoing general anesthesia were studied. Twenty-five children (group I) received oral diazepam) 0.2 mg/kg and another 25 children (group II) received oral clonidine 3 micrograms/kg, 90-120 minutes before induction of anesthesia. The level of sedation, hemodynamic changes to laryngoscopy and intubation, the recovery from anesthesia were noted and compared between the groups. Clonidine 3 micrograms/kg produced sedation comparable to diazepam 0.2 mg/kg (p > 0.1). There was significant (p > 0.01) attenuation of hemodynamic intubation response with clonidine. The recovery with clonidine was not delayed (p < 0.01). Clinically significant hypotension and bradycardia were not observed in any of the patients. We conclude that clonidine 3 micrograms/kg produces sedation comparable to diazepam 0.2 mg/kg and also attenuates the intubation response without increasing the incidence of complications.