A Comparative Clinical Study to Evaluate Efficacy of Clonidine versus Dexmedetomidine for Induced Hypotension in Functional Endoscopic Sinus Surgeries

Functional endoscopic sinus surgeries (FESS) is a surgical treatment of long-standing sinus infections like recurrent sinusitis, nasal polyps (antral or ethamoidal), fungal infections, chronic rhinosinusitis (unresponsive to medical treatment), sinonasal tumour, etc when conservative treatment fails. With advancement of technology, better illumination and visualization, there is dramatic change in surgical intervention by FESS. The important problem in the surgery is the small space, and continuous bleeding from the sinuses as sinuses have rich blood supply. The sinuses are surrounded by important organs like eyes and brain, so good surgical skill is utmost important to the surgeon for success in doing FESS surgery. Hypotensive anaesthesia is a method used to control blood pressure in a delibrate and predictable manner thereby reducing blood flow to surgical area and in turn reducing blood loss and it will improve surgical field. FESS is good to performed under the controlled hypotensive technique (i. e. mean arterial pressure (MAP) ranging from 60 and 70mmHg); this can enhance surgical field, and decrease operation time. In FESS, pre-operative intra-venous (IV) administration of the clonidine can decrease surgical time, and improve the surgical results through the less bloody field.