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Subject Area

Anesthesiology and Intensive Care

Article Type

Original Study

Abstract

Objectives The primary outcome was to compare metoprolol versus pregabalin as oral premedication to control intraoperative hemodynamics, while the secondary outcome was to assess surgical field visibility score. Background Elective lumbar spine surgeries are commonly performed under controlled hypotensive general anesthesia to ameliorate intraoperative blood loss and improve surgical field visibility. Patients and methods A total of 40 adult patients of both sexes, American Society of Anesthesiology I physical status, aged between 18 and 50 years, scheduled for elective spinal surgery during the period from August 2019 till July 2020, were randomly divided into two equal groups of 20 patients each. Group M was premedicated with 50 mg metoprolol. Group P was premedicated with 150 mg pregabalin. Oral premedication was given 90 min before the induction of anesthesia. Heart rate and mean arterial blood pressure were recorded throughout the surgery. Surgical field visibility score, surgeon satisfaction, and incidence of complications were also recorded. Data were analyzed by the variance test. Results Blood pressure and heart rate were more controlled to lower acceptable degree in metoprolol than pregabalin (P < 0.001). The surgical field visibility score was more clear with metoprolol than pregabalin (P < 0.001). Conclusion Metoprolol was found to be more effective than pregabalin in blunting hemodynamic stress response by controlling heart rate and blood pressure to lower acceptable ranges. In addition, metoprolol provided a more clear surgical field with less blood loss than pregabalin in patients undergoing spine surgery.

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