Title: Comparative Study of Oral Clonidine and Diazepam As Premedicants in Children

Authors: Anoop Prabhakaran, Raju Rajan, Geetha N K

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i6.125

Abstract

In a prospective observational study, the efficacy of oral Clonidinevis a vis Diazepamas premedicant was assessed in children undergoing elective surgery. Eighty children aged 2-12 years, undergoing general anaesthesia were studied. Forty children received oral diazepam 0.2 mg/kg (group A) and another forty children received oral clonidine 2 μg/kg(group B) 90minutes before induction of anaesthesia. The level of sedation, parental separation score, quality of mask acceptance and occurrence of complications were noted and compared between the groups. Clonidine 2 μ/kg produced sedation better than diazepam 0.2 mg/kg (p > 0.001). Parental separation score and quality of mask acceptance was much better in the clonidine group (P> 0.001).Though hypotension and bradycardia were observed in 5% of the clonidine group, it was not clinically significant. Based on composite score, none of the children in diazepam group had an acceptable score as compared to 32.5% children in the clonidine group. 60% of the diazepam group children had an unacceptable score

Keywords: Diazepam, Clonidine, Premedication.

References

1.      Bergendahl H, Lonnqvist PA, Eksborg S. Clonidine: an alternative to benzodia-zepines for premedication in children. Current Opin Anaesthesiol 2005; 18: 608–13.

2.      Bergendahl H, Lonnqvist PA, Eksborg S. Clonidine in paediatric anaesthesia: review of the literature and comparison with benzodiazepines for premedication. ActaAnaesthesiolScand 2006; 50: 135–43.

3.      Malde AD, Pagedar RA, Jagtap SR. Oral clonidine in children: efficacy as premedicant and postoperative analgesic as compared to diazepam. Indian J Anaesth. 2006 Jan 1;50(1):27-31.

4.      Wright PMC, Carabine UA McClune S Preanesthetic medication with clonidine Br J Anaest 1990;65:628-32

5.      Carabine UA, PMC Wright and J Moore, Preanaesthetic medication with clonidine: a dose-response study British Journal of Anaesthesia, 1991, Vol. 67, No. 1 79-29 .

6.      Jatti K, Batra YK, Bhardwaj N, Malhotra S. Comparison of psychomotor functions and sedation following premedication with oral diazepam and clonidine in children. Int J Clin Pharmacol Ther 1998; 36:336–9.

7.      Mikawa K, Maekawa N, Nishina K, Takao Y, Yaku H, Obara H. Efficacy of oral clonidine premedication in children. Anesthesiology 1993; 79: 926–31.

8.      Ramesh VJ, Bhardwaj N, Batra YK. Comparative study of oral clonidine and diazepam as premedicants in children. Int J ClinPharmacolTher 1997; 35: 218–21.

9.      Dahmani S, Brasher C, Stany I, Golmard J, Skhiri A, Bruneau B, Nivoche Y, Constant I, Murat I. Premedication with clonidine is superior to benzodiazepines. A meta-analysis of published studies. Actaanaest-hesiologica Scandinavica. 2010 Apr 1;54(4):397-402.

10.  Mikawa K, Maekawa N, Nishina K, Takao Y, Yaku H. Obara H. Efficacy of oral clonidine premedication in children. Anesthesiology 1993; 79: 926-31.

11.  Mikawa K, Nlshina K, Maekawa N, Obara H. Oral clonidine premedication reduces postoperative pain in children Anesth Analg 1996;82:225-30

12.  Alain Rochette, Olivier Raux, Rachel Troncin, Christophe Dadure, Regis Verdier, and Xavier Capdevila Clonidine Prolongs Spinal Anesthesia in Newborns: A Prospective Dose-Ranging Study Anesth. Anaig. 2004 98: 56-59.

13.  Constant O. Gall L Gouyet, M Chauvin, and I Murat Addition of clonidine or fentanyl to local anaesthetics prolongs the duration of surgical analgesia after single shot caudal block In childrenBr. J. Anaesth., Mar 1998; 80: 294 - 298

14.  Michael T. Pawlik, Emil Hansen, Daniela Waldhauser, Christoph Selig, and Thomas S. Kuehnel Clonidine Premedication in Patients with Sleep Apnea Syndrome: A Randomized, Double-Blind, Placebo-Controlled study Anesth. Analg. 2005 101: 1374-1380.

15.  Stoelting, R.K., "Pharmacokinetics and Pharmacodynamics of Injected and Inhaled Drugs", in Pharmacology and Physiology in Anesthetic Practice,

16.  Lippincott-Raven Publishers, 1999, 1-17 

Corresponding Author

Raju Rajan

Assistant Professor, Department of Anaesthesia

Govt. Medical College, Thiruvananthapuram