Home E-Weekly February 4, 2014

A Better Option for Pediatric Post-Op Pain?

Published: February 4, 2014

Giving pediatric patients clonidine before surgery helps to minimize their post-op pain and anxiety, notes a review appearing in the Cochrane Library.

A team of researchers analyzed the findings of 11 studies conducted worldwide involving nearly 750 children younger than 18 years old. In the trials, clonidine was compared to a placebo, midazolam (0.5mg/kg) or IV fentanyl (3mcg/kg).

According to their findings, giving 4 mcg/kg clonidine pre-operatively reduced the need for rescue analgesia when compared with the placebo and midazolam. There was no significant difference in the need for additional analgesia between clonidine and fentanyl. Additionally, the research showed patients who received 4 mcg/kg of clonidine were less likely to need additional analgesia than those who received 2 mcg/kg doses.

There were no significant side effects of clonidine, such as the severe hypotension, bradycardia or excessive sedation requiring intervention seen in powerful painkillers, note the researchers. They say clonidine was associated with only 2 side effects: lowered heart rate and lowered blood pressure.

The study's authors admit more research is needed to determine circumstances in which clonidine is most effective in children, but believe the findings may encourage physicians and healthcare professionals to consider clonidine as a premedication where post-operative pain is likely.

Daniel Cook

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