A Comparison of Premedication with Metoprolol, Clonidine and Tranexamic Acid and Intravenous Nitroglycerin on Intraoperative Hemodynamics and Surgical Conditions during Functional Endoscopic Sinus Surgery (Fess).
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 3
Abstract
Background: FESS – Functional endoscopic sinus surgery, a minimally invasive surgery, has become the main stay for treatment of patients with sinus pathology. However, Intraoperative bleeding, which reduces operative field visibility is the major problem in FESS. This study compare the effects of preoperative Clonidine, Metoprolol and Tranexamic acid with Intraoperative Nitroglycerin in patients undergoing FESS on Quality of surgical field , Intraoperative blood loss ,Hemodynamics and duration of surgery. Methods: In this study 90 patients assigned to undergo FESS were randomly allocated to three groups of 30 each. Group 1 patients were premedicated orally with Metoprolol 12.5 mg and Clonidine150mcg. Inj.Tranexamic Acid 30 mg/kg i.v. was given half an hour prior to surgery. Group II patients received NTG infusion at 2-5 mcg/kg/min, titrated to a mean arterial blood pressure of 65-75 mm/Hg. Group III underwent surgery under normotensive anesthesia. Results: Visibility of the operative field was best in Group II when compared to Group I, which was relatively better than control group. The average blood loss and mean arterial pressure was least with Group II. Mean heart rate was significantly low in Metoprolol, Clonidine and Tranexamic acid group. Conclusion : Nitroglycerin infusion have lesser blood loss, better quality of surgical field and reduced duration of surgery compared to premedication with Metoprolol, Clonidine and Tranexamic acid and normotensive anesthesia but in conditions where nitroglycerin infusion is contraindicated or not feasible, the use of Metoprolol, clonidine and Tranexamic acid may be an acceptable safer and simpler alternative.
Authors and Affiliations
Shalini Bajpai, Payal Pyati
Keywords
Related Articles
- EP ID EP595796
- DOI 10.9790/0853-1603054750
- Views 66
- Downloads 0
A Case series of two patients with unusual indications for Submental orotracheal intubation
Submental intubation serves as an effective and a less invasive alternative to tracheostomy in cases where the airway is shared with surgeons and when orotracheal and nasotracheal intubation are not feasible. It has mini...
A Prospective Study of Early Postoperative Course and Pathological Outcome of Modified D2 Gastrectomy-A Single Institute Experience
Survival after curative surgery in advanced carcinoma is not so promising. Even after use of chemotherapy, radiation therapy the goals are not met. So it is the tumour biology which is important and the future would be p...
Comparison Of Stress Response During Direct Laryngoscopic Versus Fibreoptic Orotracheal Intubation Following Premedication With Dexmedetomidine.
Introduction Laryngoscopy and intubation is known to cause a significant stress response elicited as sympathetic overactivity. This may be seen as an elevation in heart rate, blood pressure, and catecholamine levels in b...
The Growing Cancer Burden in an Urban Cancer Centre in Western Odisha: Epidemiology- A Retrospective Analysis.
All around the world, cancer manifesting in any form is one of the leading causes for death1 . In our country approximately 1 million cancer cases are detected every year and the annual deaths due to cancer is around 0.6...
Correlationbetween Serum Uric Acid Level and Glycated Haemoglobin Level inDiabetic patients Of Population of Jamshedpur, Jharkhand, India
Background:Number of people with diabetes mellitus has increasing rapidly worldwide over the past many decades and it is an important public health challenges to the country. Present study was undertaken to compare the l...