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

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 ± 67 ml on average and that in the placebo group was 276 ± 78 ml (mean ± 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.