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

Background and Aims: hypotensive anesthesia is preferred in craniotomy. Current study was conductedto evaluate the effects of oral clonidine premedication upon hemodynamic status, dural tightness andquality of anesthesia using 3 point scoring system in patients scheduled for craniotomy under generalanesthesia.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 apremedication 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, performingburr hole and during dura incision. Mean arterial pressure was highly significant for Group B duringpositioning. Heart rate change was significantly high for Group B during burr hole. Regarding duraltightness, 10 patients in Group B and 6 in Group A had no dural swelling. 1 patient in Group B and 5patients 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 neurosurgicalcomprising 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-tentorialcraniotomy.