ORAL CLONIDINE PREMEDICATION DECREASES INTRAOPERATIVE BLEEDING IN ENDOSCOPIC SINUS SURGERY

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HASHEMI S.M.; HASHEMI SEYED JALAL; JABAL AMELI M.; SOLTANINEZHAD H.A.

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Journal: JOURNAL OF ISFAHAN MEDICAL SCHOOL (I.U.M.S) Year:2004 | Volume:22 | Issue:72 Page(s): 44-49

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Title

ORAL CLONIDINE PREMEDICATION DECREASES INTRAOPERATIVE BLEEDING IN ENDOSCOPIC SINUS SURGERY

Author(s)

HASHEMI S.M. | HASHEMI SEYED JALAL | JABAL AMELI M. | SOLTANINEZHAD H.A. | Issue Writer Certificate

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Abstract

Introduction. The antihypertensive drug clonidine is a centrally acting alpha 2 agonist useful as a premedicant because of its sedative, anxiolytic, and analgesicproperties. We examined the effect of clonidine given as an oral premedication in producing a bloodless surgical field in patients undergoing endoscopic sinus surgery. We also evaluated the bleeding volume, and consumption of fentanyl and hydralazine to controlL hypotension.Methods. A prospective, randomized, double blind clinical trial study was performed in 113 patients scheduled for elective endoscpic sinus surgery under general anesthesia. Fifty- two patients received clonidine (5 mic.g/kg) 90 min prior to arrival at the operating theater and 61 received placebo (control group). The hemodynamic endpoint of the anesthetic management was maintenance of hypotension at 70 mmHg (MAP) for producing a bloodless surgical field. The desired control of the cardiovascular system was attained with halothane (inspired concentration increments of 0.5 vol % up to a maximum of 1.5 vol %) +/- fentanyl (2 mic.g/kg iv) +/- hydralazin (100 mic.g/kg) iv to a maximum of 40 mg) as needed. Intraoperative bleeding was assessed on a six- point scale from 0= no bleeding to 5 = severe bleeding.Results. There was less bleeding volume in the clonidine group (mean±SD) than in the placebo group (144±75 vs 225 ±72ml, P<0.05). Frequency of score 3 and 4 (troublesome with repeated suction) was lower in the clonidine group than in the placebo group (% 12 vs %35, P <0.05). Patients in both groups required nearly equal mean inspired halothane concentration (1.32±0.24 vs 1.35±0.21 Vol %, P> 0.05). Fentanyl requirements were significantly lower (112±18 vs 142±21 mic. g, P<0.05) in the clonidine group. Hydralazine requirements were also significantly lower (0.40±1.68 vs 2.67±4.33 mg, P<0.05).Discussion. Premedication with oral clonidine reduced bleeding in endoscopic sinus surgery and also diminished fentanyl, and hydralazine requirement for controlled hypotension.

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APA: Copy

HASHEMI, S.M., HASHEMI, SEYED JALAL, JABAL AMELI, M., & SOLTANINEZHAD, H.A.. (2004). ORAL CLONIDINE PREMEDICATION DECREASES INTRAOPERATIVE BLEEDING IN ENDOSCOPIC SINUS SURGERY. JOURNAL OF ISFAHAN MEDICAL SCHOOL (I.U.M.S), 22(72), 44-49. SID. https://sid.ir/paper/50695/en

Vancouver: Copy

HASHEMI S.M., HASHEMI SEYED JALAL, JABAL AMELI M., SOLTANINEZHAD H.A.. ORAL CLONIDINE PREMEDICATION DECREASES INTRAOPERATIVE BLEEDING IN ENDOSCOPIC SINUS SURGERY. JOURNAL OF ISFAHAN MEDICAL SCHOOL (I.U.M.S)[Internet]. 2004;22(72):44-49. Available from: https://sid.ir/paper/50695/en

IEEE: Copy

S.M. HASHEMI, SEYED JALAL HASHEMI, M. JABAL AMELI, and H.A. SOLTANINEZHAD, “ORAL CLONIDINE PREMEDICATION DECREASES INTRAOPERATIVE BLEEDING IN ENDOSCOPIC SINUS SURGERY,” JOURNAL OF ISFAHAN MEDICAL SCHOOL (I.U.M.S), vol. 22, no. 72, pp. 44–49, 2004, [Online]. Available: https://sid.ir/paper/50695/en

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