The effect of oral clonidine premedication on blood loss and the quality of the surgical field during endoscopic sinus surgery: a placebo-controlled clinical trial
The effect of oral clonidine premedication on blood loss and the quality of the surgical field during endoscopic sinus surgery: a placebo-controlled clinical trial
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DOI：
10.1007/s00540-011-1157-9
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发表时间：
2011-08-01
影响因子：
2.8
通讯作者：
Ebneshahidi, Amin
中科院分区：
文献类型：
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作者：
Mohseni, Masood;Ebneshahidi, Amin
功能性内窥镜鼻窦手术（FESS）期间出血仍然是外科医生和麻醉师的挑战，尽管有几种方法可用于改善手术野。本研究旨在评价口服可乐定术前用药对FESS术中出血量和术野质量的影响。在一项安慰剂对照临床试验中，共有84名美国麻醉医师协会（阿萨）身体状况I-II级的慢性鼻窦炎患者接受内窥镜鼻窦手术，随机分配接受口服可乐定0.2 mg或相同外观的安慰剂片剂在到达手术室前90分钟。可乐定组平均失血量为214 ± A67 ml，安慰剂组为276 ± A78 ml（均数± ASD，p < 0.01）。可乐定组的出血评分中位数（范围）显著低于安慰剂组（2（1-3）vs. 2.5（2-4），p < 0.0001）。因此，可乐定组的外科医生对术野的满意度高于安慰剂组（中位评分，4（3-5）vs. 3（1-5），p < 0.001）。结论：术前口服可乐定0.2mg可有效减少FESS术中出血。
Bleeding during functional endoscopic sinus surgery (FESS) remains a challenge for both surgeons and anesthesiologists despite several modalities available for improving the surgical field. This study was conducted to evaluate the effect of oral clonidine premedication on blood loss and the quality of the surgical field in FESS. In a placebo-controlled clinical trial, a total of 84 American Society of Anesthesiologists (ASA) physical status I-II patients undergoing endoscopic sinus surgery for chronic sinusitis were randomly allocated to receive either oral clonidine 0.2 mg or identical-looking placebo tablets 90 min before arrival at the operating room. Blood loss in the clonidine group was 214 +/- A 67 ml on average and that in the placebo group was 276 +/- A 78 ml (mean +/- A SD, p < 0.01). The median (range) bleeding score in the clonidine group was significantly lower than that in the placebo group (2 (1-3) vs. 2.5 (2-4), p < 0.0001). Accordingly, the surgeon was more satisfied with the surgical field in the clonidine group than with that in the placebo group (median score, 4 (3-5) vs. 3 (1-5), p < 0.001). In conclusion, premedication with oral clonidine 0.2 mg can effectively reduce bleeding during FESS.