Comparison Between Atenolol,Propnalol and Ivabradine

Comparison Between Atenolol , Propnalol and Ivabradine as a Premedication for Bloodless Field Anesthesia in Lumbar Spine Surgery ,a Prospective Randomized Controlled Trial

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.

Inclusion Criteria:

• ASA physical status I and II,

  • aged from 18 to 50 years old
  • scheduled for elective lumber spine surgeries will be included in this study.

Exclusion Criteria:

• Hypertension.
• Hepatic or renal disease.
• Diabetes Mellitus.
• Pregnancy.
• Coagulation disorders.
• Anemia (Hb < 10 g/dL).
• Ischemic heart disease
• Drug or alcohol abuse.
• Allergy to any of atenolol, propranolol, and ivabradine.
• History of beta-blockers, calcium channel blockers, Tricyclic antidepressants, anticoagulant or clonidine intake.