Clonidina as pediatric sedative and analgesic drug <b>[Abstract in English]</b>

Abstract

Objetive: This article reviews the clonidine use as a sedative and analgesic drug administered orally, continuous i.v. and added to local anesthesics when used in the epidural analgesia of pediatric patients.
Source of data: Review of articles selected though PUBMED, from 1999 to 2003.
Summary of the findings: Clonidine, an α-2 adrenoceptor agonist produces effetive sedation when orally administered 4 mg/kg. However, clonidine peak sedative effect is longer than midazolam. Continuous i.v. clonidine provides dose-dependent analgesia and sedation without ventilatory depression, tolerance and withdrawal with cardiovascular stability. Clonidine adjuncts to local anesthetics improve quality, as well as increase duration of analgesia when used in single-bolus injection or continuous epidural administration. It allows the use of smaller concentrations of local anesthetics avoiding the unwanted sistemic toxicity and motor blockade when larger concentrations are used.
Conclusion: Clonidine has sedative, analgesic and anxiolitic properties. This effects combination allows it’s use in wide clinical situations. Clonidine has been used most commonly as an oral premedication. Clonidine, in the intensive care, is used as a replacement for morphine in those patients who have become tolerant to opioids or who are difficult to sedate. In the postoperative, clonidine adjuncted to local anesthetics in the epidural blockade provides long-lasting analgesia without ventilatory deprression.
KEY WORDS: CLONIDINE; ADRENERGIC ALPHAAGONISTS; ANESTHESIA, EPIDURAL; ADJUVANTS, ANESTHESIA; ANESTHETICS; ANESTHETICS, LOCAL; ANALGESIA; ANALGESIA; CHILD.