COMPARING HYPOTENSIVE PROPERTIES OF DEXMEDETOMIDINE AND CLONIDINE FOR INDUCED HYPOTENSION DURING SINUS SURGERY: A RANDOMISED, DOUBLE-BLIND STUDY

Dr. Ketki Jandial* and Dr. Mamta Gupta

ABSTRACT

Background: Functional endoscopic sinus surgery (FESS) has been proposed as a selected treatment used in patients with chronic sinusitis. Due to the nature of the location of endoscopic sinus surgery, even a small amount of bleeding can reduce the operative visibility and thus cause surgeon dissatisfaction and prolong the operation trauma. This study was conducted to compare the hypotensive effectiveness and haemodynamic stability of dexmedetomidine and clonidine in patients undergoing elective FESS. Methods: 72 patients in 25-45 years age-group, posted for ambulatory FESS procedures under general anesthesia were randomly divided into two groups (n = 36 each) receiving dexmedetomidine 1μg/kg and clonidine 2μg/kg, respectively; both diluted in 10 ml saline solution 15 min before anesthetic induction. Nasal bleeding and surgeon's satisfaction score; amount and number of patients receiving nitroglycerine for analgesia and deliberate hypotension, duration of hypotension, hemodynamic parameters and side effects were recorded for each patient. Results: Nasal bleeding score,though non significant amongst the groups, was lesser with clonidine group. Again due to less bleeding and excellent operative condition, surgeon's satisfaction score was better in clonidine treated group than dexmedetomidine pretreated group but it was found to be non significant. Side effects such as nausea, vomiting, shivering were all comparable among two groups, but bradycardia and hypotension were significantly higher in Group B (P < 0.05). Conclusions: Dexmedetomidine found to be providing more effectively controlled hypotension and analgesia, and thus, allowing less nasal bleeding as well as more surgeons' satisfaction score than Clonidine with less hemodynamic alterations.

Keywords: Clonidine, controlled, dexmedetomidine, hypotension, functional endoscopic sinus surgery; mean arterial pressure.