Effects of Systemic Clonidine Administration on Blood Loss and Surgical Field Quality in Functional Endoscopic Sinus...

Control of intraoperative blood loss and improvement of surgical field quality remain among the most challenging technical issues in functional endoscopic sinus surgery (FESS). This systematic review and meta-analysis aimed to evaluate randomized clinical trials investigating clonidine in FESS, with a focus on its role in reducing blood loss and improving surgical field quality. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Nineteen studies were included in this systematic review recruiting a total of 1281 patients. In studies that compared clonidine to placebo/control, clonidine administration was associated with significantly lower blood loss [standardized mean difference (SMD) (95% CI): -1.16 (-1.86, -0.46), p = 0.001] and better surgical field quality [SMD (95% CI): -1.11 (-1.65, -0.58), p<0.0001]. In contrast, clonidine was comparable to dexmedetomidine regarding blood loss [SMD (95% CI): 0.76 (-0.10, 1.62), p = 0.08] and surgical field quality [SMD (95% CI): 0.83 (-0.17, 1.83), p = 0.1]. In conclusion, clonidine use in FESS appears to be associated with better surgical field quality and lower intraoperative blood loss when compared with placebo/control. Its effects are comparable to that of dexmedetomidine.