The purpose of this study was to measure postoperative agitation using a standardised scale and evaluate whether it is reduced if given clonidine prior to strabismus surgery as compared to placebo. The scales included the Pediatric Anesthesia Emergence Delirium (PAED) and Watcha and given, by blinded assessment, at 15 minute intervals from the time the child returned to the post-anaesthesia care unit after surgery until discharge from the unit. Follow-up was by telephone contact with parents to assess patient satisfaction and subjective degree of postoperative agitation. This prospective double blind trial included 50 patients aged eight months to 13 years. Results showed no significant difference in groups at baseline and no significant difference in PAED or Watcha outcomes at time zero or discharge or for any difference in preoperative questionnaires. The placebo group had higher Watcha scores showing more agitated behaviour but this was not significant. A statistically significant difference was seen with postoperative questionnaires. Parents of children on clonidine reports them as being sleepy at discharge and were more likely to sleep more. Older children had less incidence of postoperative agitation. The authors concluded that clonidine reduced postoperative agitation but increased drowsiness. 

Clonidine premedication versus placebo: effects on postoperative agitation and recovery time in children undergoing strabismus surgery.
Heinmiller LJ, Nelson LB, Goldberg MB, Thode AR.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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