Short summary

Pediatric surgery on extremities often requires use of a surgical tourniquet that associated with sever pain postoperatively. Clinicians have turned to off-label use of clonidine to reduce pain in this situation. No randomized controlled trial have tested the effect of intervening with clonidine and the actual extent of off-label use of clonidine for this purpose har not been described previously.

Rationale

What do we know:

Pediatric surgery on extremities often requires use of surgical tourniquets. These devices, by prevention of blood flow, allow surgery to be conducted in a bloodless operative field increasing accuracy, safety and speed. However, use of surgical tourniquet is often associated with severe pain and might prolong recovery and require increased use of supplementary opioid analgesics postoperatively for children and infants. 

The knowledge gap:

In efforts to reduce postoperative pain, clinicians have turned to off-label use of clonidine (ATC: N02CX) a drug that might reduce use of opioids and agitation postoperatively. No randomized controlled trials have tested the effect of intervening with clonidine after surgical tourniquet in children and infants, and the actual extent of off-label use of clonidine for this purpose has not been described previously. 

Link to this study:

In Denmark, off-label use of clonidine after use of surgical tourniquets in children and infants can be investigated by accessing electronic patient records. Firstly, this study will describe current utilization of clonidine in children who have lower or upper extremity surgery, where a tourniquet is used during the operation. Second, we will investigate the association between clonidine use and patient-relevant outcomes (e.g. use of opioids, duration of stay at recovery wards, registered pain levels, and observed agitation). 

Information on average prognosis will inform rationale, design, and interpretation of future randomized controlled trials.

Description of the cohort

1. Children age 0 ≤ 15 years (at the time of operation)

2. Experienced relevant surgical procedure in general anesthesia in which a tourniquet has been us.

3. ASA 1 or 2

Data and biological material

Register data: Age, Sex