Mikawa K, Nishina K, Maekawa N, Obara H
Department of Anaesthesiology, Kobe University School of Medicine, Japan.
Anesth Analg. 1996 Feb;82(2):225-30. doi: 10.1097/00000539-199602000-00001.
Clonidine is an effective preanesthetic medication in children, providing a preoperative sedative effect. The analgesic properties of the drug have been well documented in adults. The current study was designed to investigate the effect of oral clonidine given preoperatively on postoperative pain in children undergoing minor surgery. In a prospective, randomized, controlled clinical trial, 90 children aged 5-12 yr undergoing elective ophthalmic, urologic, and otologic surgery received placebo (control), clonidine 2 micrograms/kg, or clonidine 4 micrograms/kg. These drugs were administered 105 min before the estimated time of induction of anesthesia and followed by treatment with oral atropine 0.03 mg/kg 60 min before anesthesia. Anesthesia was induced and maintained with halothane and nitrous oxide in oxygen. Postoperative pain was assessed by a blinded observer using an objective pain scale (OPS). Clonidine 4 micrograms/kg provided lower OPS (highest) scores during 12 h after surgery and reduced requirement for postoperative supplementary analgesic (diclofenac suppository) compared with the other two regimens. These data suggest that oral clonidine premedication (4 micrograms/kg) is a possible approach to facilitating postoperative analgesia in children undergoing minor surgery.
可乐定是一种有效的儿童麻醉前用药，具有术前镇静作用。该药物的镇痛特性在成人中已有充分记录。本研究旨在调查术前口服可乐定对接受小手术的儿童术后疼痛的影响。在一项前瞻性、随机、对照临床试验中，90名年龄在5至12岁之间接受择期眼科、泌尿科和耳科手术的儿童接受了安慰剂（对照组）、2微克/千克可乐定或4微克/千克可乐定。这些药物在预计麻醉诱导时间前105分钟给药，然后在麻醉前60分钟用0.03毫克/千克口服阿托品治疗。使用氟烷和氧化亚氮-氧气维持麻醉诱导和维持。由一名盲法观察者使用客观疼痛量表（OPS）评估术后疼痛。与其他两种方案相比，4微克/千克可乐定在术后12小时内提供了更低的OPS（最高）评分，并减少了术后补充镇痛药（双氯芬酸栓剂）的需求。这些数据表明，术前口服可乐定（4微克/千克）可能是促进接受小手术的儿童术后镇痛的一种方法。
