Background And Aims: Bloodless surgical field during functional endoscopic sinus surgery (FESS) is an essential part, and research continues to find simple and effective regime for it. This study was aimed to compare the efficacy of oral clonidine versus oral metoprolol as premedicants regarding surgical field condition and controlled hypotension in patients undergoing FESS.
Material And Methods: Sixty-eight patients of American Society of Anesthesiologists (ASA) physical status (PS) I and II aged 18-60 years, of both genders, scheduled for FESS under general anesthesia were randomly allocated in two groups. Group C ( = 34) received oral clonidine 300 μg and group M ( = 34) received oral metoprolol 50 mg, 2 h before surgery. Controlled hypotension (mean arterial pressure [MAP] 65-75 mmHg) was achieved by titrating sevoflurane (1%-3%). Primary outcome measured was surgical field visualization by Average Category Scale (ACS 0-5), and the secondary outcomes measured were hemodynamic parameters, sevoflurane requirement, recovery, and side effects. Categorical, continuous, and ordinal data were compared using Chi-square test, -test, and Mann-Whitney test, respectively. < 0.05 was considered as statistically significant.
Results: ACS was significantly less in group C compared to group M up to 60 min, ( < 0.05). Mean systolic blood pressure (SBP), diastolic blood pressure (DBP), and MAP were significantly less in group C compared to group M at all time intervals ( < 0.05) Intraoperative sevoflurane requirement (vol %) was significantly less in group C (1.21 ± 0.42) compared to group M (1.68 ± 0.53) ( = 0.000).
Conclusions: Premedication with oral clonidine was found to be superior to oral metoprolol as it provided significantly better surgical field condition during FESS with much efficient controlled hypotension and anesthetic-sparing effect. CONSORT: http://www.consort-statement.org/.
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http://dx.doi.org/10.4103/joacp.joacp_234_23 | DOI Listing |
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Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, Department of Anesthesia and Critical Care Medicine, 1275 York Avenue, New York, NY, 10028, USA. Electronic address:
The objectives of this minireview are two-fold. The first is to discuss the evolution of opioid analgesia in perioperative medicine in the context of thoracic non-cardiac surgery. Current standard-of-care, aiming to optimize analgesia and limit undesirable side effects, is discussed in the context of multimodal analgesia, specifically enhanced recovery after thoracic surgery pathways.
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From the Department of Anesthesiology, Yale School of Medicine, 333 Cedar Street, P.O. Box 208051, New Haven, CT, 06520-8051, USA. Electronic address:
The utilization of extracorporeal membrane oxygenation (ECMO) in complex thoracic surgery has become more frequent in recent years due to advances in technology, increased availability, and improved outcomes. ECMO has emerged as a vital tool to facilitate thoracic surgery for patients who would have otherwise been deemed unsuitable candidates. It has redefined the boundaries of surgical possibility where conventional methods fall short.
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Department of Digestive Surgery, Kawaguchi Municipal Medical Center, Kawaguchi City, Saitama, 180, Nishiaraijuku333-0833, Japan.
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