Oral propranolol premedication and hypotensive anesthesia in shoulder arthroscopic surgery: a randomized controlled double-blind study

Objective The current study tested whether premedication with oral propranolol (10 mg) before hypotensive anesthesia in shoulder arthroscopic surgery could diminish reflex tachycardia following endotracheal intubation and nitroglycerine ( NTG) infusion, the amount of NTG used, and the minimum alveolar concentration ( MAC) values of inhalational anesthetic used during hypotensive anesthesia for shoulder arthroscopic surgery. Patients and methods A total of 60 American Society of Anesthesiologists ( ASA) I patients scheduled for shoulder arthroscopic surgery were included in this randomized controlled double-blinded study on oral propranolol (10 mg) or placebo as a premedication 1 h before the induction of anesthesia. Hemodynamic variables, the amount of NTG, and the MAC values of inhalational anesthetic used were recorded. Visual field visibility by the surgeon using visual analogue score was assessed. Results The heart rate, amount of NTG, and the MAC values of sevoflurane used were highly significantly lower (P 0.01) in the propranolol group; however, no significant difference (P 0.05) was found in the visual analogue score of the surgeon between the two groups. No statistically significant complications were observed in either group. Conclusion Premedication with 10 mg of oral propranolol before shoulder arthroscopic surgery was effective in achieving hypotensive anesthesia. It reduced reflex tachycardia, decreased NTG, and sevoflurane consumption without recorded complications.