Abstract
Aim: The present study was done to evaluate the role of oral clonidine and atenolol in providing optimal surgical field in nasal surgeries under general anaesthesia. Material and methods: 60 patients of ASA grade I & II posted for elective nasal surgeries were randomly divided into two groups of 30 each. Patients received 50 mg oral atenolol in group A and 100 ug oral clonidine in group B two hours prior to surgery. Induction and maintainence of anaesthesia was performed by the same standard protocol. Heart rate, systolic and diastolic blood pressure were recorded during the intra-operative and post-operative period. The surgeon, blinded to group allocation, evaluated the quality of surgical field using a predefined Average Category Scale (ACS). The amount of total blood loss was also recorded. Results: The heart rate and blood pressure were within normal range from induction to the end of the surgery in the both groups. However the difference in blood loss between groups was highly significant being less in group B (117.77 ± 7.59 ml) as compared to group A (155.73 ± 14.90 ml). This resulted in a better surgical field in group B compared to group A. Conclusion: We conclude that oral clonidine is better than atenolol in providing optimal surgical field in nasal surgeries under general anaesthesia.
Highlights
Over the past two decades, number of patients undergoing nasal surgeries for pathological and cosmetic reasons has increased
We conclude that oral clonidine is better than atenolol in providing optimal surgical field in nasal surgeries under general anaesthesia
The basic method to reduce the bleeding from the nasal mucous membranes operated on is to constrict the capillaries of the area involved. This can be accomplished by local anemization of the mucosa with vasoconstrictors, preoperative use of steroids, positioning the patient in the anti-Trendelenburg position, pharmacological cardiodepression, heart rate stabilization within lower physiological limits and the reduction in mean arterial pressure (MAP) [8]
Summary
Over the past two decades, number of patients undergoing nasal surgeries for pathological and cosmetic reasons has increased. Serious complications usually result from impaired visibility due to excessive bleeding during surgery [2]. To avoid such complications, nasal surgeries can be performed either with local anaesthesia [3], vasoconstrictors (e.g. epinephrine, cocaine and phenylephrine) [4,5] or under general anaesthesia [6]. General anaesthesia has the following apparent advantages: an immobile surgical field for performing an operation, effective protection of the respiratory tract, adequate analgesia and ventilation. There is no study which compares the effect of these two commonly used drugs for assessing the quality of surgical field in nasal surgeries
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