Open Access Research Article Singh et al., J Anesth Clin Res 2014, 5:3 DOI: 10.4172/2155-6148.1000396 Volume 5 • Issue 3 • 1000396 J Anesth Clin Res ISSN:2155-6148 JACR an open access journal Keywords: Atenolol; Clonidine; Nasal surgeries; Blood loss Introduction Over the past two decades, number of patients undergoing nasal surgeries for pathological and cosmetic reasons has increased. Tere have been limiting factors with regard to these surgeries such as blood loss [1]. 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]. But as topical anaesthesia has been associated with discomfort; general anaesthesia is preferred [3]. General anaesthesia has the following apparent advantages: an immobile surgical feld for performing an operation, efective protection of the respiratory tract, adequate analgesia and ventilation. Various drugs like beta blockers, alpha-2 agonists etc that potentiate the efect of inhalational anaesthetic agents to reduce bleeding by virtue of inhibiting sympathetic stimulation have been used. Tere are studies evaluating the efect of premedication with clonidine and atenolol on intraoperative bleeding and the need for antihypertensive drugs. But there is no study which compares the efect of these two commonly used drugs for assessing the quality of surgical feld in nasal surgeries. Tis study was conducted to compare the efcacy of oral clonidine and oral atenolol given as premedication in patients undergoing nasal surgeries for judging adequacy of surgical feld as primary outcome and intra operative blood loss and hemodynamic variables as secondary outcome. Material and Methods A randomized, double blind study was conducted on 60 patients of ASA grade I & II of either sex aged 18 to 60 years, undergoing rhinoplasty, septoplasty, and functional endoscopic sinus surgery afer approval from hospital ethics committee. Patients who had bronchial asthma, chronic obstructive pulmonary disease, diabetes mellitus, hypertension, ischaemic heart disease and who had history of hypersensitivity reaction to study drugs were excluded from the study. Afer taking informed written consent, patients were randomly divided into two groups, of 30 patients each. Te number of patients was determined by power analysis (93%) to fnd the quality of surgical feld between the two groups. In group A, patients received oral atenolol 50 mg and in group B patients received oral clonidine 100ug, 2 hr before induction of anaesthesia by number coded envelops which contained either tablet atenolol or tablet clonidine. Te hemodynamic parameters were checked in the preoperative room. On arrival in the operating room afer attaching standard monitoring, appropriate sized cannula was inserted and intravenous line started with Ringer’s lactate. Pre-oxygenation with 100% oxygen was done for 3 minutes. All patients were premedicated with inj. glycopyrronium 0.01 mg/ kg and inj butorphenol 0.02 mg/kg before induction of anaesthesia with inj. propofol 2‐3 mg/kg. Afer checking for ventilation inj. vecuronium 0.12 mg/kg was used to facilitate orotracheal intubation with a cufed endotracheal tube of appropriate size. Oropharyngeal packing was done. Local infltration of surgical site was done using 10 ml of inj 2% xylocaine with adrenaline (1: 200000). Heart rate, systolic blood pressure, diastolic blood pressure, oxygen saturation were recorded before (T b ) and afer (T i ) induction, immediately afer intubation *Corresponding author: Amrinder Singh, Department of Anesthesia, Shri Guru Ram Das Institute of Medical Sciences and Research, Punjab 143401, India, Tel: 0918427006548; E-mail: dr_amrinderpannu@yahoo.co.in Received March 06, 2014; Accepted March 27, 2014; Published March 29, 2014 Citation: Singh A, Gupta R, Bindra T, Aujla KS, Arya A, et al. (2014) A Study to Evaluate the Effectiveness of Clonidine vs Atenolol in Providing Optimal Surgical Field in Nasal Surgeries under General Anaesthesia. J Anesth Clin Res 5: 396. doi:10.4172/2155-6148.1000396 Copyright: © 2014 Singh A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. A Study to Evaluate the Effectiveness of Clonidine vs Atenolol in Providing Optimal Surgical Field in Nasal Surgeries under General Anaesthesia Amrinder Singh*, Ruchi Gupta, Tripat Bindra, KS Aujla, Anuradha Arya and Vanita Sarin Department of Anesthesia, Shri Guru Ram Das Institute of Medical Sciences and Research, Punjab, India Abstract Aim: The present study was done to evaluate the role of oral clonidine and atenolol in providing optimal surgical feld 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 feld using a predefned 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 signifcant 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 feld in group B compared to group A. Conclusion: We conclude that oral clonidine is better than atenolol in providing optimal surgical feld in nasal surgeries under general anaesthesia. J o u r n a l o f A n e s t h e s i a & C l i n i c a l R e s e a r c h ISSN: 2155-6148 Journal of Anesthesia & Clinical Research