Comparison of caudal and intravenous clonidine in the prevention of agitation after sevoflurane in children†

Böck, Matthias; Kunz, Philipp; Schreckenberger, R.; Graf, Bernhard M.; Martin, Eike; Motsch, J.

doi:10.1093/bja/88.6.790

Cited by 101 publications

(74 citation statements)

References 22 publications

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“…The effects of midazolam premedication on the incidence of EA remain controversial [9,10] and midazolam has been reported to increase the incidence of prolonged recovery [10]. a 2 -Adrenoreceptor agonists, for example clonidine and DEX, have also been used for management of EA, because of their sedative and analgesic effects [1,[5][6][7][8]14]. DEX is a more highly specific a 2 -adrenoreceptor agonist (a 2 /a 1 , 1620/1) than clonidine (a 2 /a 1 , 220/1).…”

Section: Discussionmentioning

confidence: 99%

“…To reduce the incidence of EA, prophylactic use of benzodiazepines, opioid analgesics, and a 2 -adrenoreceptor agonists have been tried, but the results have been variable [1,[5][6][7][8][9][10][11][12][13][14]. Dexmedetomidine (DEX), a highly specific a 2 -adrenoreceptor agonist (receptor selectivity, a 2 /a 1 = 1620/ 1), has sedative and analgesic properties without significant respiratory depression at clinical dosages [15,16].…”

Section: Introductionmentioning

confidence: 99%

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Effect of single-dose dexmedetomidine on emergence agitation and recovery profiles after sevoflurane anesthesia in pediatric ambulatory surgery

et al. 2010

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of single-dose dexmedetomidine on emergence agitation and recovery profiles after sevoflurane anesthesia in pediatric ambulatory surgery

et al. 2010

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“…In addition, all the children were evaluated for the state of agitation as per the modified objective pain scale [13], every 15 minutes in the recovery room during the 1 st hr after surgery, in the presence of one of the parents. The full objective pain scale included five criteria, namely, the blood pressure, crying, agitation, behavior, verbal or body expressions whereas the modified objective pain scale constituted only three [14,15]. Tears (crying), movements (agitation), behavior were those three criteria used in the modified scale.…”

Section: Research Articlementioning

confidence: 99%

Comparison of Oral Clonidine With Oral Midazolam in Managing Agitation Following Sevoflurane Anesthesia – A Prospective, Randomized, Double Blinded Study

Sethuraman

Sharma

et al. 2016

Asian J Pharm Clin Res

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Objective: Emergence agitation is a major problem during recovery from anesthetic agents like sevoflurane, particularly in children. This study had compared the effects of oral clonidine with oral midazolam in reducing the incidence of emergence agitation following sevoflurane anesthesia.Methods: A total of 50 children of ASA Status I and II aged between 3 and 8 years were randomly allotted to one of the two groups, each group comprising 25 children. Group I children were given oral midazolam 0.5 mg/kg and Group II children were given oral clonidine 4 mcg/kg 30 minutes before the induction of anesthesia. The emergence reaction was analyzed using modified objective pain scale in all children following sevoflurane administration. Results:The total agitation score was significantly less in clonidine group in comparison to midazolam group during the 1 st hr of post-operative period (p<0.05). No remarkable change in the hemodynamics or oxygen saturation was observed in both groups. Conclusion:Premedication of oral clonidine 4 mcg/kg is superior to oral midazolam 0.5 mg/kg in reducing the incidence of emergence agitation following sevoflurane anesthesia.

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“…Pain has been well investigated as a risk factor for ED, mainly in the pediatric population [42,[52][53][54][55][56][57][58][59]. The majority of research shows that adequate pain management decreases the incidence of ED.…”

Section: Nsaids and Opioidsmentioning

confidence: 99%

Emergence delirium: a narrative review

Viswanath¹,

Kerner²,

Jean³

et al. 2015

J Anesthesiol Clin Sci

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Emergence delirium (ED) is a post-surgical phenomenon associated with an increase in morbidity, mortality and resource utilization. A systematic review of all current treatment modalities for this condition is imperative given its prevalence during postoperative recovery. This review scrutinizes a number of studies in order to better characterize ED, with particular focus paid to the condition's etiology, associated risk factors, prevention and management. Extensive studies have been conducted on the pediatric population with little attention directed towards the adult and geriatric age groups. Despite this, evidence-based protocols for the management of this condition are still lacking for all age groups. In order to ensure cost effective management and improved safety outcomes for ED, future research should establish and further improve upon screening protocols to identify at risk patients, in addition to formulating a standardized treatment regimen for perioperative patients at risk. Keywords: Emergence delirium, anesthesia recovery period, anesthetic issues and peri-operative care, perioperative complications, preoperative evaluation and anesthesia risk, complications in the post anesthesia care unit

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Comparison of caudal and intravenous clonidine in the prevention of agitation after sevoflurane in children†

Abstract: Clonidine 3 micrograms kg-1 prevented agitation after sevoflurane anaesthesia, independently of the route of administration. The effect of clonidine appears to be dose-dependent, as an epidural dose of 1 microgram kg-1 failed to reduce it.

Cited by 101 publications

References 22 publications

Effect of single-dose dexmedetomidine on emergence agitation and recovery profiles after sevoflurane anesthesia in pediatric ambulatory surgery

Effect of single-dose dexmedetomidine on emergence agitation and recovery profiles after sevoflurane anesthesia in pediatric ambulatory surgery

Comparison of Oral Clonidine With Oral Midazolam in Managing Agitation Following Sevoflurane Anesthesia – A Prospective, Randomized, Double Blinded Study

Emergence delirium: a narrative review

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