A comparison of effect of oral pre-medication with clonidine and metoprolol on intraoperative hemodynamics and surgical conditions during functional endoscopic sinus surgery 

• Author Details:   
• Baseeha Sereen V.A
• Swadika Natarajan
• Balasubramanian Arunkumar
• Shanu Shanmugasundaram ^*
• Panneerselvam Periasamy
• Arbind Kumar Choudhary

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Background: Maintaining hemodynamic stability and minimizing blood loss are critical goals in perioperative care. Clonidine, an α2-adrenergic agonist, and Metoprolol, a selective β1-blocker, are frequently used to modulate cardiovascular responses during surgery. Their comparative efficacy in reducing intraoperative blood loss and supporting postoperative recovery remains a subject of clinical interest. The aim of this study was to compare the perioperative efficacy of oral clonidine and metoprolol in maintaining intraoperative hemodynamic stability, minimizing blood loss, and enhancing postoperative recovery among adult patients undergoing elective surgery under general anaesthesia.

Materials and Methods: This prospective, randomized controlled trial included 60 ASA I–II patients aged 18–60 years undergoing elective surgery under general anaesthesia. Participants were randomized to receive either oral Clonidine (0.15 mg, Group A, n=30) or Metoprolol (50 mg, Group B, n=30) two hours before surgery. Intraoperative hemodynamic parameters, estimated blood loss, surgical field quality, and postoperative outcomes including pain score, nausea incidence, recovery time, and hospital stay were recorded and statistically analysed.

Results: The intraoperative heart rate, blood pressure, and oxygen saturation remained stable in both groups, with no statistically significant differences observed (P > 0.05). However, the Clonidine group demonstrated a significantly lower mean intraoperative blood loss compared to the Metoprolol group (137 ± 14.71 mL vs. 151 ± 9.94 mL; P = 0.0002), along with superior surgical field visibility, as reflected by a higher proportion of "Good" field assessments (70% vs. 56.7%; P = 0.041). Postoperative parameters, including pain scores, recovery time, and duration of hospital stay, showed no significant differences between the two groups (P > 0.05).

Conclusion: Clonidine and Metoprolol are both effective for intraoperative hemodynamic control and postoperative recovery. However, Clonidine demonstrates a distinct advantage in minimizing blood loss and improving surgical field quality.