Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 10 1 2023 10 08 3 8 Komal Garg Department of Anaesthesia, SMS Medical College and Hospital, Rajasthan University of Health Sciences, Jaipur, India. Samridhi Nanda Department of Anaesthesia, SMS Medical College and Hospital, Rajasthan University of Health Sciences, Jaipur, India. Usha Bafna Department of Anaesthesia, SMS Medical College and Hospital, Rajasthan University of Health Sciences, Jaipur, India. Chandan Mali Department of Anaesthesia, SMS Medical College and Hospital, Rajasthan University of Health Sciences, Jaipur, India. Sumaila Naaz Department of Anaesthesia, SMS Medical College and Hospital, Rajasthan University of Health Sciences, Jaipur, India. Nelwin Sabu Department of Anaesthesia, SMS Medical College and Hospital, Rajasthan University of Health Sciences, Jaipur, India. 2023 03 28 2023 05 29 Background: FESS has its share of complications which can be a challenge for both the surgeon as well the anesthetist and achieving a bloodless surgical field is essential So the principle of controlled hypotension can be used to combat this issue. Methods: A hospital-based randomized comparative interventional study was conducted on 60 patients to compare Clonidine (2mcg/kg in 10 ml of saline over 10 minutes before induction followed by an infusion of 1mcg/kg/hr during maintenance) and Esmolol (1mg/kg in 10 ml of saline over 10 minutes before induction followed by an infusion of 1mg/kg/hr during maintenance) to assess and compare the hypotensive properties of both the drugs. Results: After the induction of anesthesia, there was a significant difference in the mean heart rate, and mean arterial pressure between the two groups throughout the intraoperative period (p-value < 0.05). Both groups achieved a target mean arterial pressure (MAP) of 65-70 mmHg and improved surgical field quality. Conclusion: This study concluded that clonidine and esmolol both provide hemodynamic stability and a better surgical field in functional endoscopic sinus surgery (FESS). Clonidine also helps in achieving postoperative sedation and analgesia. https://aacc.tums.ac.ir/index.php/aacc/article/view/729