Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

Comparing the Effect of Oral Clonidine and Tranexamic Acid on Bleeding and Surgical Field Quality during Functional Endoscopic Sinus Surgery

Document Type : Original

Authors
Jahangir Ghorbani 1
Shima Arastou 2
Ali Safavi Naeini 3
Nasim Raad 3
Mahboobeh Karimi Galougahi 3
Alireza Jahangirifard 4
Nader Akbari Dilmaghani 5
1 Chronic Respiratory Disease Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Department of Rhinology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 Tracheal Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4 Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
5 Hearing Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
10.22038/ijorl.2018.27591.1902
Abstract
Introduction:
Bleeding during functional endoscopic sinus surgery (FESS) is an important issue for both anesthesiologists and surgeons as it can affect the safety and efficiency of the procedure. We compared the efficacy of tranexamic acid (TXA) and clonidine in reducing blood loss and improving surgical field visualization during FESS.
 
Materials and Methods:
In a double-blind, randomized, clinical trial, 52 patients, American Society of Anesthesiologists (ASA) physical status 1–2, aged 13–75 years, suffering from rhinosinusitis with or without polyposis, and who were candidates for FESS, were enrolled. The first group received intravenous TXA 15 mg/kg diluted in 100 ml normal saline, administered during 10-min infusion after induction. In the second group, 0.2 mg oral clonidine was given 1 to 1.5 hours before surgery. Duration of surgery, hemoglobin level, heart rate, blood pressure, and quality of surgical field based on Boezzart's scale and surgeon satisfaction based on Likert's scale were recorded in both groups.
 
Results:
In total, 52 patients, 27 (51.9%) males and 25 (48.07%) females were studied. Twenty-two (42.3%) and 30 (57.7%) were in the TXA and clonidine groups, respectively. The mean pre- and post-surgical hemoglobin level showed no meaningful difference between the two groups. The same result was obtained for blood pressure and heart rate at different time points (P>0.05). Mean anesthesia time (P=0.859), mean surgical time (P=0.880), surgeon's satisfaction of the surgical field (P=0.757) and surgical field quality at different time points revealed no significant difference between the two groups.
 
Conclusion:
Premedication with oral clonidine and intravenous TXA has the same effect on bleeding during FESS, surgical field visualization, and surgeon satisfaction.
Keywords
Bleeding
Rhinosinusitis
Clonidine
Polyposis
Tranexamic acid
Sinus
Surgery
Subjects
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Iranian Journal of Otorhinolaryngology
Volume 30, Issue 5 - Serial Number 100
September and October 2018
Pages 255-260