Acta Anaesthesiol Scand 2003; 47: 90–93 Copyright C Acta Anaesthesiol Scand 2003 Printed in Denmark. All rights reserved ACTA ANAESTHESIOLOGICA SCANDINAVICA 0001-5172 Oral clonidine premedication does not reduce postoperative vomiting in children undergoing strabismus surgery N. GULHAS 1 , A. TURKOZ 2 , M. DURMUS 1 , T. TOGAL 1 , E. GEDIK 3 and M. O. ERSOY 4 1 Department of Anesthesia, Inonu University Turgut Ozal Medical Center, 2 Department of Anesthesia, Anesthetist, School of Medicine, Baskent University, Adana, Turkey Background: We evaluated the effect of oral clonidine on post- operative vomiting (POV) in children undergoing strabismus surgery. Methods: Eighty ASA physical status I children aged 3–12 years were randomly assigned to one of two groups in a double-blinded manner. One hour before surgery, each patient in the clonidine group (nΩ40) received clonidine 4 mg kg ª1 in apple juice 0.2 ml kg ª1 , and each of the controls (nΩ40) received apple juice 0.2 ml kg ª1 only. The protocol for general anesthesia was propofol-sevo- flurane in N 2 O/O 2 . A paracetamol suppository was administered in each case to prevent postoperative pain. Patient responses dur- ing 0–48h after anesthesia were recorded as complete (no POV, no antiemetic rescue required), retching, vomiting, or rescue antiem- etic. Results: There were no significant differences between the cloni- T HE INCIDENCE of postoperative vomiting (POV) in children undergoing strabismus surgery who have not been treated with antiemetics is 45–85% (1). As a result of the remarkably high incidence, a number of preventative antiemetic approaches have been investigated (2,3). Clonidine, an a 2 -adrenocep- tor agonist, is an effective premedicant for children: it has been shown to prevent the sympatho-adre- nergic response to anesthesia, reduce anesthetic re- quirements, and provide preoperative sedation, post- operative analgesia, and perioperative hemodynamic stability (4). Two recent studies have also shown that premedication with oral clonidine reduces POV after pediatric strabismus surgery (5,6). We investigated the effect of oral clonidine on the incidence of POV in children undergoing strabismus surgery in a prospective, double-blind, randomized study. 90 dine and control groups regarding the number of patients with complete response (21 vs. 18, respectively) retching (10 vs. 14, re- spectively), vomiting (19 vs. 22, respectively), or rescue antiemetic (9 vs. 12, respectively) during the first 48 h. Conclusion: Oral premedication with clonidine 4 mgkg ª1 did not reduce the rate of POV in the children undergoing strabismus surgery. Accepted for publication 20 August 2002 Key words: clonidine; postoperative vomiting; strabismus surgery. c Acta Anaesthesiologica Scandinavica 47 (2003) Methods The hospital Ethics Committee gave approval for the study, and we obtained informed parental consent to enrol 80 children scheduled for strabismus surgery. All patients were ASA physical status I, and the age range was 3–12 years. The exclusion criteria were gas- trointestinal disease and obesity (defined as 20% heavier than the ideal body weight) Previous prob- lems with vomiting or history of motion sickness were noted for each case. All subjects fasted for 6 h before induction of anesthesia, and clear liquids were per- mitted until 2h before surgery. The sealed-envelope method was used to randomly assign the children to one of two groups. One hour before surgery, each pa- tient in the clonidine group (nΩ40) received clonidine 4 mg kg ª1 mixed in apple juice 0.2 ml kg ª1 , and the controls (nΩ40) received the same amount of plain