{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T09:09:32Z","timestamp":1788858572052,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100020265","name":"Stan Perron Charitable Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["2009322"],"award-info":[{"award-number":["2009322"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001136","name":"Australian and New Zealand College of Anaesthetists","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001136","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009099","name":"Reinholdt W. Jorck og Hustrus Fond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009099","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Preoperative anxiety is common in children and is associated with emergence delirium\u2014a distressing postoperative complication characterized by agitation and disorientation. Midazolam has long been the drug of choice for preoperative anxiolysis. More recently, \u03b1\n                      <jats:sub>2<\/jats:sub>\n                      adrenoceptor agonists, such as clonidine, have gained popularity for their sedative and analgesic properties. The effect of these agents on the incidence of emergence delirium remains uncertain. This study evaluated whether premedication with clonidine or midazolam is associated with emergence delirium in children undergoing general anesthesia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a post hoc analysis of prospectively collected data pooled from 10 clinical studies, comprising data from 4796 general anesthetics in children (0\u201316\u2009years). The studies were carried out at a tertiary pediatric hospital in Perth, Australia. We assessed the impact of premedication with clonidine or midazolam on the incidence of emergence delirium using validated scales.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In this cohort, with a mean age of 6.8 (range: 0.03\u201316.97), 331 children received clonidine and 731 received midazolam. Overall, the incidence of emergence delirium was 6%. Primary propensity score\u2013matched analyses found no significant association between clonidine (OR 1.19, 95% CI 0.65\u20132.16) or midazolam (OR 1.23, 95% CI 0.79\u20131.92) and emergence delirium. In our secondary adjusted logistic regression models, midazolam was associated with increased odds of emergence delirium, whereas clonidine showed no statistically significant association overall.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The overall incidence of emergence delirium was low. While clonidine showed no statistically significant association with emergence delirium, our secondary multivariate analysis suggests midazolam might be associated with an increased risk of emergence delirium.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pan.70275","type":"journal-article","created":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T08:22:57Z","timestamp":1785572577000},"page":"1290-1307","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the Impact of Clonidine and Midazolam Premedication on Emergence Delirium in Pediatric Patients"],"prefix":"10.1002","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1149-9946","authenticated-orcid":false,"given":"Anne Louise de Barros","family":"Garioud","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Juliane Marie Centre Copenhagen University Hospital\u2014Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7801-0347","authenticated-orcid":false,"given":"Anwen","family":"Taplin","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain Medicine Perth Children's Hospital, Child and Adolescent Health Service  Perth Western Australia Australia"},{"name":"Perioperative Medicine Team, The Kids Research Institute Australia  Perth Western Australia Australia"},{"name":"Institute for Paediatric Perioperative Excellence The University of Western Australia  Perth Western Australia Australia"},{"name":"School of Physics, Mathematics and Computing The University of Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6315-0225","authenticated-orcid":false,"given":"Yufei","family":"Shang","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain Medicine Perth Children's Hospital, Child and Adolescent Health Service  Perth Western Australia Australia"},{"name":"Perioperative Medicine Team, The Kids Research Institute Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3349-5006","authenticated-orcid":false,"given":"R. Nazim","family":"Khan","sequence":"additional","affiliation":[{"name":"Perioperative Medicine Team, The Kids Research Institute Australia  Perth Western Australia Australia"},{"name":"Institute for Paediatric Perioperative Excellence The University of Western Australia  Perth Western Australia Australia"},{"name":"Department of Mathematics and Statistics The University of Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3600-1315","authenticated-orcid":false,"given":"David","family":"Sommerfield","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain Medicine Perth Children's Hospital, Child and Adolescent Health Service  Perth Western Australia Australia"},{"name":"Perioperative Medicine Team, The Kids Research Institute Australia  Perth Western Australia Australia"},{"name":"Institute for Paediatric Perioperative Excellence The University of Western Australia  Perth Western Australia Australia"},{"name":"Division of Emergency Medicine, Anaesthesia and Pain Medicine, Medical School The University of Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8868-0690","authenticated-orcid":false,"given":"Neil","family":"Hauser","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain Medicine Perth Children's Hospital, Child and Adolescent Health Service  Perth Western Australia Australia"},{"name":"Perioperative Medicine Team, The Kids Research Institute Australia  Perth Western Australia Australia"},{"name":"Institute for Paediatric Perioperative Excellence The University of Western Australia  Perth Western Australia Australia"},{"name":"Division of Emergency Medicine, Anaesthesia and Pain Medicine, Medical School The University of Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8418-5572","authenticated-orcid":false,"given":"Aine","family":"Sommerfield","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain Medicine Perth Children's Hospital, Child and Adolescent Health Service  Perth Western Australia Australia"},{"name":"Perioperative Medicine Team, The Kids Research Institute Australia  Perth Western Australia Australia"},{"name":"Institute for Paediatric Perioperative Excellence The University of Western Australia  Perth Western Australia Australia"},{"name":"Division of Emergency Medicine, Anaesthesia and Pain Medicine, Medical School The University of Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8043-8541","authenticated-orcid":false,"given":"Britta S.","family":"von Ungern\u2010Sternberg","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain Medicine Perth Children's Hospital, Child and Adolescent Health Service  Perth Western Australia Australia"},{"name":"Perioperative Medicine Team, The Kids Research Institute Australia  Perth Western Australia Australia"},{"name":"Institute for Paediatric Perioperative Excellence The University of Western Australia  Perth Western Australia Australia"},{"name":"Division of Emergency Medicine, Anaesthesia and Pain Medicine, Medical School The University of Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,1]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjao.2025.100411"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X0303100114"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000136471.36680.97"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2010.03281.x"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40272-016-0201-5"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-024-02889-w"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-200107000-00022"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9592.1998.00724.x"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2009.02207.x"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12587"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0000000000000724"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aem071"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2007.02332.x"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-200101000-00011"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.14740"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200405000-00015"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3182a66b76"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03008224"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/88.2.241"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.2307\/2533160"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000001270"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/5142913"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.2147\/DDDT.S163828"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2004.00525.x"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeh093"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.14279"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000005915"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.2147\/DDDT.S461122"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199311000-00009"},{"key":"e_1_2_15_5_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwq224"},{"key":"e_1_2_15_5_9_3_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v045.i03"},{"key":"e_1_2_15_5_9_4_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v042.i08"},{"key":"e_1_2_15_5_9_5_1","doi-asserted-by":"publisher","DOI":"10.32614\/RJ\u20102021\u2010073"},{"key":"e_1_2_15_5_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539\u2010199710000\u201000012"},{"key":"e_1_2_15_5_9_7_1","first-page":"599","volume-title":"Breaktrough in Statistics I","author":"Leeuw J.","year":"1992"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pan.70275","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pan.70275","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pan.70275","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T08:33:09Z","timestamp":1788856389000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pan.70275"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,1]]},"references-count":36,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/pan.70275"],"URL":"https:\/\/doi.org\/10.1002\/pan.70275","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"value":"1155-5645","type":"print"},{"value":"1460-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,1]]},"assertion":[{"value":"2026-03-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}