• Nitu Puthenveettil, Sunil Rajan, Lakshmi Kumar, and Suresh Gangadharan Nair.
• Department of Anaesthesia and Critical Care, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India.
• Anesth Essays Res. 2013 Sep 1; 7 (3): 371-5.

ContextEstablishing a near perfect surgical field during functional endoscopic sinus surgery (FESS) is essential and even a minor bleeding can severely compromise an already restricted view. So, if controlled hypotension can be provided without compromising the safety of patient by a relatively effortless method, surgical field can be improved greatly.AimsThe aim of this study was to compare the hemodynamic changes and surgical conditions during FESS following oral premedication with clonidine and metoprolol.Settings And DesignA total of 40 patients undergoing FESS were included in this prospective, randomized controlled study.Subjects And MethodsPatients were divided into two equal groups. Group A patients were premedicated with oral clonidine 300 mcg and Group B with oral metoprolol 50 mg, 2 h before surgery. All patients received fentanyl 2 mcg/kg and induced with propofol 2 mg/kg. Intubation was done following vecuronium 1 mg/kg. Anesthesia was maintained with 66% N2O, 33% O2 and 1% isoflurane. The heart rate (HR) and blood pressure (BP) were measured before induction and thereafter every 15 min up to 2 h. The surgeons were asked to estimate the quality of the operative field using a pre-defined category scale with scores 1-5.Statistical AnalysisDifference within the groups was analyzed using analysis of variance and post-hoc test was used to test the difference between individual groups. Chi-square test was used to find out the association between categorical variables.ResultsComparison of category scale revealed a lower score in Group A up to 60 min. Group B patients showed a statistically lower HR from pre-induction up to 90 min while systolic BP (SBP), diastolic BP (DBP) and mean arterial pressure did not show a significant difference.ConclusionsOral premedication with 300 mcg of clonidine produced a better operative field than oral metoprolol 50 mg during FESS.

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