EFFECTS OF ORAL CLONIDINE PREMEDICATION ON PLASMA-GLUCOSE AND LIPID HOMEOSTASIS ASSOCIATED WITH EXOGENOUS GLUCOSE-INFUSION IN CHILDREN

Background: Oral clonidine may influence plasma glucose and Lipid home ostasis by modulating endocrinologic responses to surgical stress. The effect of oral clonidine premedication on plasma glucose and lipid ho meostasis associated with exogenous glucose infusion were investigated in children undergoing minor surgery. Methods: Otherwise healthy chil dren (n, 120; aged 3-13 yr) were assigned randomly to six groups accor ding to the glucose concentration of the intravenous solution (0%, 2%, or 5%, at a rate of 6 ml kg(-1).h(-1)) and the preoperative medicatio ns (4 mu g/kg clonidine or placebo given 100 min before anesthesia) th ey were to receive. The plasma concentrations of glucose, nonesterifie d fatty acid, ketone bodies, epinephrine, norepinephrine, and cortisol were determined.Results: Infusion of 5% glucose caused hyperglycemia (mean glucose concentration >200 mg/dl) in six children receiving plac ebo and two receiving clonidine. Although the mean plasma glucose conc entration increased in three placebo groups, it was unchanged and the plasma concentrations of total ketone bodies and nonesterified fatty a cid were increased in children receiving clonidine and glucose-free so lution. The plasma epinephrine, norepinephrine, and cortisol levels in children receiving placebo increased in response to surgery. Clonidin e attenuated the increase in catecholamines and cortisol. Conclusions: Oral clonidine premedication attenuated the hyperglycemic response, p robably by inhibiting the surgical stress-induced release of catechola mines and cortisol Infusion of 2% of glucose maintained plasma glucose concentrations within physiologic ranges in children receiving clonid ine.