In a double-blinded trial, 40 male children (age 2-7 yr) undergoing circumcision 
were randomly assigned to receive clonidine 2 microg/kg IV or placebo after 
anesthetic induction. For induction and maintenance of anesthesia, we used 
sevoflurane as the sole anesthetic. For pain treatment, a penile block was 
performed before surgery. After surgery the incidence and severity of agitation 
was measured during an observation period of 2 h. Severe agitation was treated 
with midazolam. In 16 placebo and 2 clonidine-treated patients agitation was 
observed (P < 0.001). In 6 patients of the Placebo group, agitation was graded 
as severe, whereas none of the patients in the Clonidine group developed severe 
agitation (P = 0.02). During the postoperative period heart rate and blood 
pressure were significantly decreased in clonidine treated patients (P < 0.05). 
We conclude that clonidine effectively prevents agitation after sevoflurane 
anesthesia.
IMPLICATIONS: The recovery from sevoflurane anesthesia may be complicated by the 
presence of agitation in pediatric patients. Clonidine 2 microg/kg IV after 
anesthetic induction effectively reduces the incidence of agitation without 
resulting in clinically relevant bradycardia and hypotension.