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Comparative evaluation of atenolol and clonidine premedication on cardiovascular response to nasal speculum insertion during trans-sphenoid surgery for resection of pituitary adenoma: A prospective, randomised, double-blind, controlled study.

Gupta D, Srivastava S, Dubey RK, Prakash PS, Singh PK, Singh U - Indian J Anaesth (2011)

Bottom Line: We enrolled 66 patients in age range 18-65 years, of ASA I-II, and of either sex undergoing elective sublabial rhinoseptal trans-sphenoidal hypophysectomy.Group I (control) received placebo, group II (clonidine) received tablet clonidine 5 µg/kg, and group III (atenolol) received tablet atenolol 0.5 mg/kg.We therefore suggest that oral clonidine and oral atenolol (given 2 hours prior to surgery) is an equally effective and safe method of attenuating haemodynamic response caused by nasal speculum insertion during trans-sphenoid pituitary resection.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.

ABSTRACT
Severe cardiovascular responses in the form of tachycardia and hypertension following nasal speculum insertion occur during sublabial rhinoseptal trans-sphenoid approach for resection of small pituitary tumours. We compare the effects of preoperative administration of clonidine (α-2 agonist) and atenolol (α-blocker) over haemodynamic response, caused by speculum insertion during trans-sphenoid pituitary resection. We enrolled 66 patients in age range 18-65 years, of ASA I-II, and of either sex undergoing elective sublabial rhinoseptal trans-sphenoidal hypophysectomy. Group I (control) received placebo, group II (clonidine) received tablet clonidine 5 µg/kg, and group III (atenolol) received tablet atenolol 0.5 mg/kg. The heart rate increased on speculum insertion and 5 and 10 minutes following speculum insertion as compared to the pre-speculum values in the control group, while no change in the heart rate was observed in other groups (P<0.05). There was a rise in the mean arterial pressure during and 5, 10, and 15 minutes after nasal speculum insertion in the control group, whereas it was not seen in other groups (P<0.05). We therefore suggest that oral clonidine and oral atenolol (given 2 hours prior to surgery) is an equally effective and safe method of attenuating haemodynamic response caused by nasal speculum insertion during trans-sphenoid pituitary resection.

No MeSH data available.


Related in: MedlinePlus

Changes in heart rate. Data are presented as mean values. * denotes P<0.05 comparing control with other groups
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Figure 0001: Changes in heart rate. Data are presented as mean values. * denotes P<0.05 comparing control with other groups

Mentions: Baseline HR and MAP were comparable in all three groups (P>0.05). On speculum insertion, the HR increased as compared to the pre-speculum values in control and other groups during speculum insertion, 5 and 10 minutes following speculum insertion, while it was not seen in the clonidine and atenolol group (P<0.05) [Figure 1] [Table 1]. There was an increase in MAP in the control group, while it was not seen in clonidine and atenolol group during speculum insertion, and 5, 10, and 15 minutes following speculum insertion (P<0.05) [Figure 2] [Table 2]. The HR and MAP reached to their pre-insertion value following the removal of speculum. After removal of speculum, the HR and MAP became insignificant as compared to their baseline value (P>0.05).


Comparative evaluation of atenolol and clonidine premedication on cardiovascular response to nasal speculum insertion during trans-sphenoid surgery for resection of pituitary adenoma: A prospective, randomised, double-blind, controlled study.

Gupta D, Srivastava S, Dubey RK, Prakash PS, Singh PK, Singh U - Indian J Anaesth (2011)

Changes in heart rate. Data are presented as mean values. * denotes P<0.05 comparing control with other groups
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3106385&req=5

Figure 0001: Changes in heart rate. Data are presented as mean values. * denotes P<0.05 comparing control with other groups
Mentions: Baseline HR and MAP were comparable in all three groups (P>0.05). On speculum insertion, the HR increased as compared to the pre-speculum values in control and other groups during speculum insertion, 5 and 10 minutes following speculum insertion, while it was not seen in the clonidine and atenolol group (P<0.05) [Figure 1] [Table 1]. There was an increase in MAP in the control group, while it was not seen in clonidine and atenolol group during speculum insertion, and 5, 10, and 15 minutes following speculum insertion (P<0.05) [Figure 2] [Table 2]. The HR and MAP reached to their pre-insertion value following the removal of speculum. After removal of speculum, the HR and MAP became insignificant as compared to their baseline value (P>0.05).

Bottom Line: We enrolled 66 patients in age range 18-65 years, of ASA I-II, and of either sex undergoing elective sublabial rhinoseptal trans-sphenoidal hypophysectomy.Group I (control) received placebo, group II (clonidine) received tablet clonidine 5 µg/kg, and group III (atenolol) received tablet atenolol 0.5 mg/kg.We therefore suggest that oral clonidine and oral atenolol (given 2 hours prior to surgery) is an equally effective and safe method of attenuating haemodynamic response caused by nasal speculum insertion during trans-sphenoid pituitary resection.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.

ABSTRACT
Severe cardiovascular responses in the form of tachycardia and hypertension following nasal speculum insertion occur during sublabial rhinoseptal trans-sphenoid approach for resection of small pituitary tumours. We compare the effects of preoperative administration of clonidine (α-2 agonist) and atenolol (α-blocker) over haemodynamic response, caused by speculum insertion during trans-sphenoid pituitary resection. We enrolled 66 patients in age range 18-65 years, of ASA I-II, and of either sex undergoing elective sublabial rhinoseptal trans-sphenoidal hypophysectomy. Group I (control) received placebo, group II (clonidine) received tablet clonidine 5 µg/kg, and group III (atenolol) received tablet atenolol 0.5 mg/kg. The heart rate increased on speculum insertion and 5 and 10 minutes following speculum insertion as compared to the pre-speculum values in the control group, while no change in the heart rate was observed in other groups (P<0.05). There was a rise in the mean arterial pressure during and 5, 10, and 15 minutes after nasal speculum insertion in the control group, whereas it was not seen in other groups (P<0.05). We therefore suggest that oral clonidine and oral atenolol (given 2 hours prior to surgery) is an equally effective and safe method of attenuating haemodynamic response caused by nasal speculum insertion during trans-sphenoid pituitary resection.

No MeSH data available.


Related in: MedlinePlus