Premedicationin children: compative study of oral clonidine and diazepam

Abstract Introduction: Surgery & Anesthesia can be a traumatic experience to child & considerable emotional stress for both parents & children. The development of a sedative premedication in children that is a traumatic, well accepted & easily administrated is the need hour today. Aims & Objectives: The Aim of the study was to compare the efficacy of oral clonidine & oral diazepam with respect to sedative, anxiolytic effect ,behavior at separation from parent & also to compare the haemodynamic changes associated with tracheal intubation & interaoperatively & to study the side effect of both, if any. Material & Methods: 60 Children of age group 4 to 12 years belonging to ASA grade I & II were selected. The effect of Clonidine 4 micro gm/kg. were compared with Diazepam 0.4 mg/kg as an oral premedication in children. The drugs were administrated 90 min. prior to the surgery. The assessment of heart rate, blood pressure & level of sedation were mentioned at 10min interval. The hild’s behavior at the time of separation from parent was noted. Anesthesia was induced with Inj. Pentothal sodium 5 to 7 mg/kg IV & tracheal intubation was facilitated with Inj. Succinylcholine 2 mg/kg. Haemodynamic changes after tracheal intubation were compared among thre two groups. Results: Patient in the two groups all of whom underwent surgery lasting for >1.5 hour.(i.e. tonsillectomy,cleft palate etc) were comparable with respect to age, weight premedication time & anesthesia time. The group receiving 4 microgram/kg clonidine showed increased sedation at 30,60 & 90 min. after premedication compared with diazepam group. Clonidine produced better quality of separation from parents than diazepam 0.4 mg/kg. by applying chi-square test this result was proved to statistically significant. Clonidine attenuated the blood pressure & heart rate increases associated with tracheal intubation. The percent change in the average maximum systolic & diastolic blood pressure or heart rate associated tracheal intubation was significantly less in clonidine group than diazepam group. This observation was statistically significant by applying unpaired t-test. There were no significant differences among the two group in preoperative vital signs. No children in the clonidine group had intraoperative or postoperative hypotension or bradycardia. Conclusion: Thus, oral clonidine 4 microgram/kg is an effective & safe premedication in healthy children undergoing the surgeries lasting for >1.5 hour & is found to be better than diazepam.