Controlled hypotension with balanced anaesthesia minimises blood loss. Doctors Meghna Jiwanmall, Anita Shirley Joselyn, and Subramani Kandasamy from CMC Vellore, performed a study to evaluate the effectiveness of intravenous clonidine as a single bolus dose to establish controlled hypotension during functional endoscopic sinus surgery (FESS).
A randomised, double-blind, placebo-controlled study was done in a tertiary hospital in India to study the Intravenous clonidine as a part of balanced anaesthesia for controlled hypotension in functional endoscopic sinus surgery. Sixty American Society of Anesthesiologists physical status I and II patients (18–65 years) undergoing FESS were randomly allocated to one of the two groups. Placebo group (group A, n = 30) received sterile water whereas the clonidine group (group B, n = 30) received 3μg/kg of clonidine intravenously, 30 min prior to induction of anaesthesia. The primary outcome was to achieve a target mean arterial blood pressure (MAP) of 55–65 mmHg intraoperatively. The secondary outcomes measured were requirement of additional fentanyl and metoprolol, intra-operative blood loss, surgeon’s opinion on the surgical field, pain, sedation score and complications requiring treatment.
Study Results showed that target MAP was easily achieved in clonidine group as against the placebo group (P < 0.001). Significant reduction in intra-operative blood loss, a better surgical site scoring, less requirement of additional hypotensive drugs and good analgesia were seen in clonidine group. The complication rates were similar in both the groups.
The author with this study concluded that Clonidine is effective in achieving controlled hypotension in patients undergoing FESS. It reduces intra-operative blood loss, requirement of additional hypotensive drugs, improves the surgical field and offers good analgesia without significant side effects.
The article is published in May 2016 issue of Indian Journal of Anesthesia, the official journal of Indian Society of Anaesthesiologists.
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Jiwanmall M, Joselyn AS, Kandasamy S. Intravenous clonidine as a part of balanced anaesthesia for controlled hypotension in functional endoscopic sinus surgery: A randomised controled trial. Indian J Anaesth [serial online] 2017 [cited 2017 May 31];61:418-23. Available from: http://www.ijaweb.org/text.asp?2017/61/5/418/205998