Mydhili K.1, Sreehari K.G.2, Vijayakumari Y.3, Tanuja T.V.L.4
BACKGROUND
Bleeding during functional endoscopy sinus surgery (FESS) remains a main
consideration. Even a small amount of blood may disturb the endoscopic view,
increasing the likelihood of complications. So, we decided to compare the effects
of clonidine and atenolol as oral premedication for hypotensive anaesthesia in
patients undergoing FESS under general anaesthesia. The purpose of this study
was to analyse and compare the efficacy of oral atenolol versus oral clonidine as
premedication under general anaesthesia for induced hypotension in patients
undergoing a functional endoscopic sinus surgery.
METHODS
The study included total 100 patients of age (18 – 60 years) [American Society of
Anaesthesiologists (ASA grade I and II)] who were randomly divided into two
groups of 50 each. Group - A (n = 50), a non-labelled clonidine tablet PO was
given to the patients in the clonidine group in the dose of 2 mcg/kg at 7 pm the
day before surgery and 4 mcg/kg two hours before surgery. Group - B (n = 50),
a non-labelled atenolol 25 mg tablet was given PO to the patients in the atenolol
group at 7 pm the day before surgery and also 2 hours before surgery. Induction
and maintenance of general anaesthesia was performed by the same standard
protocol for both groups. Hemodynamic effects [heart rate (HR), systolic blood
pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP),
quality of surgical field, intraoperative complications, and post anaesthetic
discharge score system (PADSS)] were recorded and statistically analysed.
RESULTS
The hemodynamic stability and good quality surgical field was obtained in both
the groups. The lesser incidence of intraoperative complications recorded with
atenolol gives it a more favourable profile when compared to clonidine.
CONCLUSIONS
We conclude that both oral clonidine and atenolol premedication provides superior
and predictable perioperative hemodynamic control, reduces the requirement of
hypotensive agents, and produces acceptable recovery characteristics. The lesser
incidence of intraoperative complications recorded with atenolol gives it a more
favourable profile when compared to clonidine.
