Clevidipine for deliberate hypotention in functional endosopic sinus surgery [FESS]

ABSTRACT

Clevidipine or nitroglycerine was used to induce controlled hypotension in patients undergoing functional endoscopic sinus surgery [FESS]. Objective: Evaluation of clevidipine as a hypotensive agent in comparison to nitroglycerine in FESS. Method: Forty patients were randomly assigned to the clevidipine or nitroglycerine group. All patients received standard anaesthetic technique. A target mean arterial pressure [60 mm Hg] was achieved by adjusting infusion rate of the hypotensive agent. The two groups were compared with reference to heart rate [HR], mean arterial blood pressure [MAP], cardiac index [Cl], stroke index [SI], and systemic vascular resistance index [SVRI]. Quality of surgical field was compared using average category scale [ACS]. Results: Mean HR was significantly higher in nitroglycerine group during steady state hypotension [p = 0.009].Reflex tachycardia was more frequent in nitroglycerine group [45% vs 10%]. Mean SVRI was significantly lower in clevidipine group [p < 0.001]. ACS was better in clevidipine group. Clevidipine was effective in inducing controlled hypotension in FESS and it offered better surgical field than nitroglycerine