Discussion
anxiety, disorientation, hyperactivity, agitation, postoperative shivering, hypersensitivity
HYPERSENSITIVITY
We conducted a prospective randomized clinical trial to evaluate the efficacity of clonidine in reducing perioperative children´s anxiety. Our study demonstrates that intranasal clonidine is effective in preoperative anxiety, preoperative and postoperative sedation, quality of induction and intubation, quality of awakening after anesthesia, and quality of immediate postoperative period compared to intranasal placebo when it is used as a premedication in children proposed for tonsillectomy.Clonidine is in increasing use in the pediatric population as an anxiolytic, sedative, and analgesic because of its central alpha2-adrenergic agonist effect [Clonidine is responsible for sedation close to physiological sleep from which the patient can be easily awakened and in possession of his cognitive faculties. It has even been shown that once awake, patients are quite capable of carrying out psychomotor tests [All these studies have shown that patients who received clonidine premedication accepted the face mask better than those who received another molecule, thanks to the anxiolytic effect provided by clonidine. Post-anesthetic agitation is a common problem in children who have undergone general anesthesia with sevoflurane. This agitation is characterized by a change in the child's perception of his environment with signs of disorientation, hypersensitivity to stimuli, and hyperactivity. Our study showed that intranasal clonidine reduced significantly postoperative agitation. Zhang In our study, we noted a single case of postoperative shivering in the clonidine group versus 16 children in the placebo group with a significant difference (p<0.001). A Cochrane meta-analysis [Our study has several limitations such as the choice of the sedation evaluation scale. We used it for the evaluation of the sedation on the WHO sedation scale. However, it is a scale applicable after the use of opioid products and whose validity in young patients is still limited.