Effect of premedication with oral clonidine on intraoperative blood loss during rhinoplasty surgery - A systematic review

Abstract

Rhinoplasty is one frequent surgical procedure of many technical variations that only a few surgeons are considered to have mastered its broad scope. Operative site bleeding is considered to be an exasperating issue in the surgical procedure of rhinoplasty. Over the past few decades, the strategy of lowering patient's blood pressure during anaesthesia or "Hypotensive anaesthesia" has been practised to reduce the blood loss during surgeries. Clonidine is an antihypertensive drug and is suggested to have advantageous effects in controlling the intraoperative blood loss. The objective of this systematic review was to explore and study the existing literature and determine the efficacy of oral clonidine as a premedication in reducing the intraoperative blood loss in rhinoplasty surgeries. Data was gathered from electronic databases like PubMed, Medline and Cochrane central library. An additional manual search was performed with various journals to look for available articles to include in the systematic review. Only those studies which met the criteria for inclusion were selected. All studies and reports that evaluated oral clonidine with placebo in reducing bleeding during rhinoplasty surgery were included. Pertinent literature abstracts and full-text articles pertaining to the query were analysed. Two articles in total were taken in for qualitative analysis, both of which were randomised clinical trials. Oral clonidine shows significantly more efficient in reducing intraoperative bleeding than the placebo group. Premedication with oral clonidine is significantly effective in controlling blood loss during the surgical procedure of rhinoplasty.