The aim of this work is to compare atenolol, propranolol, and ivabradine as a premedication to achieve bloodless field anesthesia primarily controlling heart rate in lumbar spine surgery.
This study will investigate the effect of atenolol, propranolol, and ivabradine as oral premedication in adult patients undergoing LUMBAR SPINE SURGERY to achieve bloodless field anesthesia. AIM OF THE WORK * The primary aim of this work is to compare atenolol, propranolol, and ivabradine as a premedication to achieve bloodless field anesthesia primarily controlling heart rate in lumbar spine surgery. * The secondary aims are to assess field visibility and measure the amount of blood loss in patients, and surgeon satisfaction and also to asses if there are any associated undesirable side effects of atenolol, propranolol, or Ivabradine will appear.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
120
patients will be premedicated with atenolol (50mg)
patients will be premedicated with propranolol (10mg)
patients will be premedicated with Ivabradine (5mg)
Menoufia University
Shepien El Kom, Menoufia Government, Egypt
Perioperative Heamodynamic Effect of the drugs
Heart rate
Time frame: every 5 minutes for 15 minutes and then every 10 minutes till end of surgery, then every 15 minutes for 1hour in the recovery room
Blood loss & surgical field visibility score
quality scale proposed by Fromm and Boezaart
Time frame: Intraoperative time
Anesthetic consumption
Propofol, opioid, and isoflurane consumption
Time frame: Intraoperative time
Incidence of complication
The patient will be examined for bradycardia, or tachycardia hypo or hypertension, shivering, respiratory depression, dizziness, visual disturbance, nausea, and vomiting
Time frame: Intraoperative time
The need for blood transfusion
The need for blood transfusion
Time frame: Intraoperative time
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