Abstract

EFFECTS OF CLONIDINE BASED ANESTHESIA AND DEXMEDETOMIDINE IN FUNCTIONAL ENDOSCOPIC SINUS SURGERY: A COMPARATIVE STUDY

Akhil Gupta and Rumani Ruku*

ABSTRACT

Introduction: FESS (Functional endoscopic sinus surgery) is a surgical treatment of long-standing sinus infections. Hypotensive anesthesia is often used to control blood pressure, reduce blood flow to surgical area, and reduce blood loss and to improve surgical field. FESS is better to be performed under controlled hypotensive technique (mean arterial pressure, MAP, between 55 and 65 mmHg). Alpha 2 agonists, like, Clonidine and more recently Dexmedetomidine have been used in anesthetic practice to achieve controlled hypotension. This study was undertaken to compare the hemodynamic changes and surgical conditions during FESS following oral premedication with clonidine or Dexmedetomidine. Method: A prospective, randomized controlled study was conducted in GMC Jammu on 50 patients undergoing FESS, in the age-group of 18 to 60 years. Patients were divided into two equal groups: Group 1 consisted of patients premedicated with oral clonidine 300 μg and Group 2 with oral Dexmedetomidine 50 mg, both 2 Hours before surgery. Results: Heart Rate (HR) showed significant lowering in Group 2. MAP was successfully reduced to the target value of 55 to 65 mmHg in both the groups, but showed significant drop in Group 2 as compared to Group 1 at 15 & 30 min interval. The blood loss during surgery was significantly reduced in both groups, while intra-operative analgesic requirement in the dexmedetomidine group was significantly reduced as compared to the clonidine group. Conclusion: Dexmedetomidine provided improved reduction in HR, reduced analgesic requirements and significant postoperative sedation compared to clonidine.

Keywords: Functional Endoscopic Sinus Surgery, Hypotensive Anesthesia, Dexmedetomidine, Clonidine, Mean arterial pressure, Heart Rate.