(HealthDay News) — Clonidine premedication at adequate dosage (4 µg/kg) seems likely to have a beneficial effect on postoperative pain in children, according to a review published online January 28 in The Cochrane Library.

Paul Lambert, from the Women’s and Children’s Hospital in Adelaide, Australia, and colleagues conducted a systematic literature review to examine the effectiveness of clonidine versus placebo, when given as a premedication, in reducing postoperative pain in children <18 years of age. Eleven trials, involving 742 children were identified and included in the study.

The researchers found that the overall quality of the evidence from pooled trials was low or had unclear risk of bias. Substantial methodological heterogeneity was seen between the trials. Oral clonidine premedication at 4µg/kg reduced the need for additional analgesia compared with placebo (risk ratio [RR] 0.24). Furthermore, there was a reduction in additional postoperative analgesia in one small trial comparing clonidine (orally at 2 or 4µg/kg) with oral midazolam (0.5mg/kg) (RR, 0.25). A single, higher-quality trial comparing 4 with 2 µg/kg clonidine showed a significant difference in the number of patients requiring additional analgesia in favor of the higher dose (RR, 0.38).

“Further research is required to determine under what conditions clonidine premedication is most effective in providing postoperative pain relief in children,” the authors write.

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