Online ISSN: 2515-8260

Keywords : Clonidine

A Study Of Effect Of Pre-Emptive Oral Clonidine On Intraoperative Hemodynamics And Surgical Field Quality During Functional Endoscopic Sinus Surgery (FESS) Under General Anesthesia.

Dr. Kapil K. Khandelwal; Dr. Jayashree Sen

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 3544-3551

Background: In functional endoscopic sinus surgery(FESS), because of highly vascular nasal mucosa, excessive intraoperative bleeding may impair visibility of the surgical field causing complications. To limit this, intraoperative controlled hypotension can be adopted.Clonidine (centrally acting α2 agonist), has antihypertensive property with decreasing sympathetic outflow. Prior to surgery, oral Clonidine used during the anaesthetic procedure, would potentiate the action of inhalation agents to cause hypotension without having the disadvantages for using intravenous vasodilators.Besides, Clonidine premedicant decreases analgesic requirementand nausea, vomiting post-operatively. Aim and Objectives: The present study aims at the analysis of the effects of clonidine as an oral premedicant in patients who are undergoing Functional Endoscopic Sinus Surgery. The objectives are to assess the efficacy of oral clonidine A. primarily, a. as a hypotensive agent while used along with the technique of balanced anaesthesia b. on intraoperative bleeding following a score on bleeding severity B. secondarily, a. in maintaining a stablehaemodynamic status intraoperatively with/ without requirements of rescue antihypertensive drug, b. in evaluating any side effect and/or complication which may originate while using clonidine as premedicant. Methodology: 60 patients selected will be divided randomly into two groups: 1. Group C (n= 30, Clonidine group): given Clonidine (200 μgm), 2. Group P (n= 30, Placebo group): given Placebo.
Both orally with a sip of water 60 min before anaesthetic induction time.
To shrink nasal mucosal vessels, all patients will receive nasal packing of 2% xylocaine with 1:200000 adrenaline. Then, 60 minutes after study drugs are given, patients will beshifted for procedure.Using Six-point Average Category Scale, the grading of surgical field in terms of bleeding, will be done by the operating surgeon. Expected Results: Oral clonidine premedicant, in FESS patients, will effectively reduce bleeding during the procedure and will offer a favorable surgical outcome achieving controlled hypotension.

Astudy to Compare the Analgesic Efficacy of Intra-Articular Levobupivacaine, Fentanyl And Clonidine Following Arthroscopic Knee Surgery

Dr Abhilash Dash; Dr Rabi Narayan Dhar; Dr Sidharth Sraban Routray; Dr Syed Sabir Ali

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 6, Pages 1160-1165

Arthroscopic knee surgery can produce pain postoperativelywhich can be very distressing. Many drugs in variousways have been tried to overcomethis pain. But none found to be most effective.So we have done a study for correlating with the analgesiclevobupivacaine efficiency, fentanyl, & clonidine into intra-articular therapy associated with arthroscopic surgeries. This study was conducted from Nov 2019 to April 2020, in which 90 patients undergoing arthroscopicsurgery of knee split in 3classes of 30 each. (L,F,C). ClassL were injected 10 millilitrein levobupivacaine of 0.26% e, where ClassF wereinjected 50 mcg fentanyl, and Class Cwere injected 50 mcg of clonidine in intra-articular therapyafter surgery. Time of first analgesia request, no of analgesic dose required and total rescue analgesic required in postoperative 24 hours were assessed. Pain was assessed using visual analogue scale. Demographic characteristicsweresimilaramong allthe three Classs. Time for need of 1stanalgesic request in ClassL was 381.57 ± 24.63 min, in ClassF was 328.67 ± 20.42 min and in Class C was 238.47 ± 21.93 minutes.(p<0.06)Overall amount ofdoses of analgesic needed was fewer in ClassL (1.21 ± 0.57) in comparison to ClassF (1.95 ± 0.42) and Class C (2.12 ± 0.34). (p<0.05) Total dose of paracetamol used was reduced in ClassLcorrelated withClassF and C in 1st 24 hrs postoperatively. (p<0.05) Class F & C has highest average score of VAS at various time points in 1st 24 hrs correlated withClass L.(p<0.05) Intra-articular levobupivacaine obtained better control of pain inpostoperative period with delayed time of need of 1st analgesicdose and reduced the need of total dose of rescue analgesicin comparison to intra-articular clonidineandfentanyl.