PURPOSE: Postoperative agitation is common in adults and children following the 
use of several anesthetics, particularly inhalation anesthetics. This behavior 
has detrimental effects both physically for the patient following the procedure 
and psychologically for the parent or guardian. The authors propose that 
clonidine, an alpha-2 agonist, would provide a reduction in children's 
postoperative agitation and, in turn, improve parent satisfaction in children 
undergoing strabismus surgery.
METHODS: Fifty children were prospectively randomized to receive either 
clonidine or placebo in a double-blind fashion prior to surgery. The children 
were evaluated using preoperative and postoperative parent questionnaires and 
postoperative behavioral evaluation using standardized scales including the 
Pediatric Anesthesia Emergence Delirium and Watcha scales.
RESULTS: Children receiving clonidine immediately after anesthesia induction had 
statistically significant improvement in postoperative agitation at the 
15-minute mark (P = .096) and last score obtained (P = .095) using the Watcha 
scale. The clonidine group spent an insignificantly longer time in the 
post-anesthesia care unit (average: 54 minutes) than the placebo group (average 
47 minutes) (P = .17). Seventy-one percent of parents reported being "very 
satisfied" with their child's recovery from anesthesia in the clonidine group 
compared to 46% in the placebo group, although this was not statistically 
significant (P = .34).
CONCLUSIONS: Children receiving clonidine prior to undergoing strabismus surgery 
have a small but noticeable reduction in postoperative agitation, stay slightly 
longer in the post-anesthesia care unit, and have higher rates of parent 
satisfaction.