Anesthesia for a child with deletion 3q syndrome

[No abstract available

Premedication in children: a comparison of oral midazolam and oral clonidine

Background: Oral premedication is widely used in pediatric anesthesia to reduce preoperative anxiety and ensure smooth induction. Midazolam is currently the most commonly used premedicant, but good results have also been reported with clonidine. The aim of the present study was to compare clinical effects of oral midazolam and oral clonidine. Methods: We performed a prospective open study in 64 children who were randomly assigned to receive either oral midazolam 0.5 mg.kg (-1) (group M) or oral clonidine 4 mu g.kg (-1) (group C) prior to mask induction. Drug acceptance, preoperative sedation and anxiolysis, quality of mask acceptance, recovery profile and parental satisfaction were evaluated. Results: The taste of oral clonidine was judged as significantly better; 14% of children rejected oral midazolam. Onset of sedation was significantly faster after premedication with midazolam (30 +/- 13.1 min) than with clonidine (38.5 +/- 14.6 min), but level of sedation was significantly better after premedication with clonidine. Quality of mask induction was equally successful in both groups. A steal-induction was performed in 66% of patients of group C, but none in group M. We observed a trend towards an increased incidence of emergence agitation after premedication with midazolam. Parental satisfaction was significantly higher in group C. Conclusions: In this study, premedication with oral clonidine appeared to be superior to oral midazolam. Quality of mask acceptance was comparable between groups, but oral clonidine was better accepted by the child, produced more effective preoperative sedation, showed a trend towards better recovery from anesthesia and had a higher degree of parental satisfaction

Absorption pharmacokinetics of clonidine nasal drops in children

Background: The α2 agonist clonidine has become a popular drug for premedication in children. Effects and pharmacokinetics after oral, rectal, and intravenous administration are well known. The aim of this study was to investigate the absorption pharmacokinetics of clonidine nasal drops in children. Methods: Thirteen ASA I pediatric patients received after induction of anesthesia 4 mcg·kg -1 of clonidine by the nasal route. Blood samples were taken during a 12-h period and plasma levels of clonidine were analyzed by liquid chromatography-mass spectrometry. Data were calculated by a computer-aided curve-fitting program. Results: Plasma pharmacokinetics following administration of clonidine nasal drops showed a considerable interindividual variability and absorption was delayed and limited. A total of 95% confidence intervals for maximum plasma concentration and time to achieve maximum plasma concentration were 0.4-0.6 ng·ml -1 and 1.4-3.0 h, respectively. Conclusions: Clonidine nasal drops are erratically absorbed from the nasal mucosa and, thus, this mode of drug administration is not recommended for premedication purposes. © 2008 The Authors

Effects of sevoflurane and clonidine on acid base status and long-term emotional and cognitive outcomes in spontaneously breathing rat pups - Fig 1

<p><b>(A): Elevated Plus Maze (EPM) at adolescence and adulthood.</b> Percentage of entries in the open arms (OE). Results are expressed as mean ± standard error of mean (SEM). There was no difference among groups (n = 10 per group; p > 0.05). (<b>B): Elevated Plus Maze (EPM) at adolescence and adulthood</b> Percentage of time spent in the open arms (TO). Results are expressed as mean ± standard error of mean (SEM). There was no difference among groups (n = 10 per group; p > 0.05).</p

Demographic data.

<p>Demographic data.</p

Inhibitory avoidance test (IA) at adolescence and adulthood.

<p>Inhibitory avoidance test (IA) at adolescence and adulthood.</p

Blood gas analysis.

<p>Blood gas analysis.</p

Ultrasound vocalization (USV) and homing test at infancy.

<p>Ultrasound vocalization (USV) and homing test at infancy.</p