Role of clonidine premedication as a part of hypotensive anaesthesia during functional endoscopic sinus surgery: A placebo-controlled study

Abstract

Objective: The present study was performed to evaluate the effectiveness of intravenous Clonidine as a part of premedication in controlled hypotensive anaesthesia during functional endoscopic sinus surgery (FESS). Material & Methods: It was a prospective study carried out in the department of Anaesthesia of a tertiary care centre of Rajasthan, India. 50 patients undergoing FESS surgery for chronic sinusitis were included in the study and were divided into two groups viz. group I, who were given normal saline and group II, who were given intravenous Clonidine 3μ/kg as a part of premedication prior to induction. The outcomes were measured by estimation of mean arterial pressure (MAP), extra requirement of isoflurane and nitrogycerine (NTG) to achieve target MAP, blood loss during the surgery, duration of surgery and post-operative complications. Results: Both the groups were matched in terms of age, sex and weight parameters. There was statistically significant difference between MAP in group I and group II before induction, average intra-operative and during immediate post-operative period. The requirement of extra isoflurane or NTG to achieve target MAP was high ( in 56% patients) and moderate (in 44% patients) in group I while low requirement was needed in 60% of group II cases and rest 40% cases didn’t required any extra isoflurane or NTG. The average amount of blood loss in group II was significantly less (230±66 ml) than group I (356±75 ml). Similarly, the duration was 76±16 minutes in group I surgery and 59±12 minutes in Clonidine group. Quality of surgical field as per Boezart score was significantly better in Clonidine group. The incidence of postoperative complications like bradycardia, hypotension and prolonged sedation were not significant in both the groups. Conclusion: Clonidine is cheap and safe drug to use for controlled hypotensive anaesthesia without any significant side effect in FESS.