Effects of clonidine on hemodynamic response and dural tightness in patients with supratentorial space occupying lesion undergoing craniotomy- a placebo controlled comparative study

Abstract

Background and Aims: hypotensive anesthesia is preferred in craniotomy. Current study was conducted
to evaluate the effects of oral clonidine premedication upon hemodynamic status, dural tightness and
quality of anesthesia using 3 point scoring system in patients scheduled for craniotomy under general
anesthesia.
Methodology: Amongst twenty two selected cases they were grouped equally in this randomized single
– blind comparative study. Group A and B patients received sugar tablet and oral clonidine 3 μg/kg as a
premedication respectively. Monitoring of hemodynamic variables like heart rate, systolic arterial pressure,
diastolic arterial pressure, mean arterial pressure, SpO2, ETCO2 and dural tightness were performed.
Results: Diastolic arterial pressure was significantly low in Group B during positioning, performing
burr hole and during dura incision. Mean arterial pressure was highly significant for Group B during
positioning. Heart rate change was significantly high for Group B during burr hole. Regarding dural
tightness, 10 patients in Group B and 6 in Group A had no dural swelling. 1 patient in Group B and 5
patients in Group A had minimal swelling and surgery continued. Once all results b being assessed using
‘Three point scoring system’, it became highly significant in Group B with respect to Group A.
Conclusion: Oral clonidine premedication provides optimal hemodynamic stability and good neurosurgical
comprising heart rate, mean arterial pressure and dural tightness. ‘Three point scoring system’
seems to be an effective tool for intra-operative monitoring of patients undergoing supra-tentorial
craniotomy.