Evaluation of Oral Clonidine Premedication on Intraoperative Blood Loss and Bleeding Severity Score in Functional Endoscopic Sinus Surgery – A Prospective Placebo Controlled Study

Effect of oral clonidine premedication on PR interval in patients undergoing rhinoplasty and functional endoscopic sinus surgery (FESS)

“…[1][2] Post-surgical cardiac incidents and the occurrence of hypertension and tachycardia during the emergence from anesthesia necessitate vigilant measures to maintain cardiovascular stability. [3][4] Various pharmacological interventions, including β-blockers, α2-agonists, calcium channel blockers and nitroglycerin, have been used to attenuate the cardiovascular effects stemming from heightened sympathetic system activation. 1 Excessive bleeding encountered during ENT surgeries interferes with the surgical field, leading to complications and suboptimal outcomes.…”

“…2 Various pharmacological agents, such as magnesium sulfate, vasodilators, nitroglycerin, volatile anesthetics, β-blockers, and α2-agonists, including clonidine, are employed to induce controlled hypotension and minimize intraoperative bleeding. 3 Clonidine help in modulating arterial blood pressure and heart rate, thereby reducing intraoperative bleeding. 3 Acting selectively on α2-receptors with 200 times greater affinity than α-receptors, clonidine primarily functions as an antihypertensive agent, inhibiting norepinephrine release and consequently curbing sympathetic activity and peripheral vasodilatation.…”

“…3 Clonidine help in modulating arterial blood pressure and heart rate, thereby reducing intraoperative bleeding. 3 Acting selectively on α2-receptors with 200 times greater affinity than α-receptors, clonidine primarily functions as an antihypertensive agent, inhibiting norepinephrine release and consequently curbing sympathetic activity and peripheral vasodilatation. [5][6][7] Apart from its hemodynamic effects, clonidine induces negative chronotropy, hypotension, 5,[8][9][10][11][12] and exhibits sedative properties through stimulation of α2-receptors in the central nervous system.…”

Induced hypotensive anesthesia by using premedication Atenolol in comparison to intraoperative Nitroglycerin during Functional Endoscopic Sinus Surgery (FESS)

“…Functional endoscopic sinus surgery FESS has been a major advancement in the management of a chronic sinusitis and other sino-nasal diseases (Masrat et al, 2001) There are some . limiting factors in this surgery and the main consideration is blood loss because mucosal bleeding often interferes with the optimal visualization of the intranasal anatomy (Rice, 1995).…”