Evaluation of Oral Clonidine Premedication on Intraoperative Blood Loss and Bleeding Severity Score in Functional Endoscopic Sinus Surgery – A Prospective Placebo Controlled Study
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2014, Vol 4, Issue 10
Abstract
Background: Bleeding during functional endoscopic sinus surgery (FESS) remains a challenge for both surgeons and anaesthesiologists despite several modalities available for improving the surgical field. This study was conducted to evaluate the effect of oral clonidine premedication on blood loss and the quality of the surgical field in FESS. Methods: This prospective placebo controlled trial was performed on 120 patients (ASA I, ASA II). Patients undergoing endoscopic sinus surgery for chronic sinusitis and nasal polyposis were randomly allocated to receive either oral clonidine 0.005mg/kg or identical-looking placebo tablets 90 min before arrival at the operating room. During general anaesthesia, the hemodynamic endpoint of the anaesthetic management was maintenance of hypotension (Mean Arterial Presure) at ≤ 65 mmHg for producing a bloodless surgical field. The control of MAP was attained with inspired concentration increments of halothane up to maximum of 1.5 vol % as needed. Intraoperative bleeding was assessed on a six – point scale from 0 (= no bleeding) to 5 (= severe bleeding). Data were compared with chisquare test, fisher's exact test and Student t-test. Results: There was less bleeding volume in the clonidine group (mean±SD) than in the placebo group (140.7±65.4 Vs 199.2±104.4, P<0.05). Frequency of bleeding severity scores 3 and 4 (troublesome with repeated suction) were lower in the clonidine group than in the placebo group (13.3 Vs 33.3%, P< 0.05). ). Accordingly, the surgeon was more satisfied with the surgical field in the clonidine group than with that in the placebo group. Conclusion: In conclusion, premedication with oral clonidine can effectively reduce bleeding during endoscopic sinus surgery.
Authors and Affiliations
Masrat Jan, Fayaz A. Reshi, Shiwalika Gupta, Shaugfta Aara, Iftikhar H. Wani, Basharat Saleem
Keywords
Related Articles
- EP ID EP349075
- DOI 10.9734/BJMMR/2014/4168
- Views 72
- Downloads 0
CT Scan Patterns of Stroke at the University of Gondar Hospital, North West Ethiopia
Background: In places like rural Ethiopia where there is no CT or MRI, the diagnosis of stroke remains by clinical signs and symptoms. Knowing the actual proportion of the types of stroke seen locally is helpful in the p...
The Rabbit Model of Femoral Bone Defects: Steps to Overcome Potential Pitfalls
Aims: To identify the potential pitfalls and indicate procedures to prevent them, during the evaluation of biomaterials for orthopaedic and craniofacial research in the New Zealand White (NZW) rabbit animal model of femo...
Surgical Management of Haemangiolymphangioma - An Infrequent Tumor in Oral Cavity: A Case Report and a Review
Hemangiomas are group of vascular anomalies which are not present at birth. They generally manifest within 3-4 weeks of life, consists of a rapid proliferative phase, stable plateau phase and slow involuting phase. Heman...
Corneal Thinning and Opacity following Selective Laser Trabeculoplasty: A Case Report
Aims: Selective laser trabeculoplasty (SLT) (Lumenis, Santa Clara, CA) was developed in 1999 as a means to lower IOP in patients with glaucoma. It is a relatively safe procedure. We report a rare side effect of corneal...
Therapeutic Effect of Curcumin Supplementation in the Modulation of NF-κB Responsive Genes in a Collagen-induced Arthritis Rat Model
Aims: To assess the therapeutic effect of curcumin supplementation in modulating the expression of NF-κB in the joints of collagen-induced arthritis (CIA) rats. Place and Duration of Study: Department of Postgraduate Stu...