Efficacy of Oral Clonidine as Pre-Anesthetic Medication in Reduction of Post-Operative Pain in Children-A Randomized Controlled Trial

Clonidine is α₂ agonist antihypertensive drug but its use is limited because of multiple adverse effects including sedation. Clonidine also has effective pre-anesthetic and analgesic-properties that have been well documented in adults in different parts of the world. This drug has substantially decrease opioid or volatile anaesthetics requirements with definite improvement of cardiovascular markers. The current study was designed to investigate the efficacy of oral clonidine as pre-anaesthetic medication in reduction of post-operative pain among Bangladeshi children. This randomized, controlled trial was performed in year 2010–2011 in a private medical college in Bangladesh. A total of 60 children aged 3 months-3 years undergoing minor surgery received placebo (control) and clonidine 4μg/kg, 100 min before induction of anesthesia and followed by oral atropine 0.03 mg/kg, 60 minutes before anesthesia. Anaesthesia was induced and maintained with halothane and nitrous oxide with oxygen. Post-operative pain was assessed using objective pain scale (OPS). Clonidine provided lower OPS scores and reduced requirement for postoperative supplementary analgesic compared to the control. These data suggest that oral clonidine is a possible approach to facilitate post-operative analgesia in children undergoing minor surgery.