One of the crucial times in pediatric surgery is after surgery because it is within this stage that a doctor may start managing child pain and distress. Kids display a variety of emotions when they are subjected to pain or stress and they can get over these feelings only after a long time has passed. They may even develop trauma after the procedure. Thus, the search to for better pain and anxiety management after pediatric surgery is on. Strong painkillers and other medications cannot be used on children since this will place kids at risk for many complications and side effects.
Clonidine and Post-Operative Recovery
A recent Cochrane review has found out that clonidine when administered to kids before surgery can relieve post-operative pain and reduce anxiety in them. This review was done by researchers from the Women’s and Children’s Hospital at the University of Adelaide in Australia. The results showed that when clonidine was given at 4 micrograms/kg after surgery, there was a reduced risk of side effects compared to when it was not administered. However, the potential side effects associated with clonidine administration were a lower heart rate and a lower blood pressure. The researchers reviewed eleven studies conducted in the US, China, Japan, Jordan, Turkey, Canada, Greece and Sweden. These eleven studies involved more than 700 children under the age of 18 and tried to find out whether clonidine was effective in relieving pain and discomfort after surgery. Clonidine was compared with the effects of other medications such as midazolam and fentanyl in some of these studies. The findings of this review suggested that physicians and other health care personnel should consider using clonidine as pre-medication when the patient is likely to experience post-operative pain. The researchers claimed that clonidine may be the answer to problems of post operative pain and potential complications after pediatric surgery. However they admitted that more studies are needed to justify this medication's use.
More About Catapres
Clonidine is being marketed under the Catapres brand and is being used for hypertension. It is a centrally acting medication which can lower blood pressure due to its alpha-receptor binding effect. It is available in three dosage strengths: 0.1 mg, 0.2 mg and 0.3 mg. The medication literature states that it may have adverse effects which are usually mild and usually tend to go away with continued treatment. The most frequent adverse events are dry mouth, drowsiness, dizziness and constipation. Rarely, the user may experience side effects such as fatigue, fever, weakness, pallor, alcohol sensitivity, and withdrawal syndrome. Very few patients may also experience bradycardia, heart problems, electrocardiographic abnormalities, orthostatic symptoms, Raynaud’s phenomenon, and palpitations; the user may also experience agitation, anxiety, delirium, hallucinations, behavioral changes, paresthesia, sleep disorder, vivid dreams or nightmares, depression, alopecia, rash, hives, abdominal pain, body malaise, abnormal liver function tests, decreased sexual activity, difficult urination, thrombocytopenia, leg cramps, blurring of vision, and other problems. However these side effects are rare and do not develop normally in users.
Precautions should be taken in using clonidine in patients with hypersensitivity to this drug, in cases of severe coronary insufficiency, cerebrovascular disease, chronic renal failure, recent myocardial infarction, and conduction disturbances of the heart. This drug was not known to promote cancer in several studies and may have no effect on fertility. No well-controlled documented studies have been performed in pregnant women so that it is under Pregnancy Category C. There are also no well-controlled documented studies in children, so that its safety in children is not yet well-known. Clonidine should only be used under the supervision of a physician and must be used according to its indications as approved by the FDA.
If you want to know more on how to prepare your child for surgery, you can check our other articles on this site.