The Effect of Oral Propranolol on Intraoperative Bleeding in Minimally Invasive Gastric Bypass Surgery in Patients Admitted to Rasoul Akram Hospital: A Randomized Clinical Trial

Background: Surgical treatment of patients with morbid obesity is now the most successful way to return to active life and overcome its effects. Complications during surgery still are varied and plentiful. One of the most important of these effects is increased bleeding during surgery, which increases the duration of surgery and possibly the need for reoperation. The use of propranolol in other surgeries has had a beneficial effect in reducing bleeding, a finding that has not yet been investigated in bariatric surgery. Methods and Materials: In the double-blind study, 82 patients were randomly assigned to two groups receiving propranolol 40 mg or placebo twice daily for one week before surgery. The patients then underwent gastric bypass surgery. The bleeding, the need for hemostasis, and blood loss during surgery were evaluated. Results: Of the studied patients, 24.4% were male and 75.6% were female. The Mean±SD of BMI in the intervention group was 44.1±4.2 and in the control group was 44.07±3.5 kg/m2 and no difference was observed between the two groups. The mean number of bleeding was 2.13±0.84 and 2.5±1.03 in the intervention and control groups, respectively, and this difference was statistically significant between the two groups. The time needed for hemostasis in the intervention and control groups was 7.96±3.85 and 9.67±5.01, respectively, which this difference was statistically significant. The type of injury was arterial in 79 patients (96.3%) and venous in 3 patients (3.7%), and no statistically significant difference was seen between the two groups (P=0.967) The mean hemoglobin was 13.6 before surgery and 12.9 after surgery, but there was no significant difference between the level of hemoglobin before and after the surgery. Conclusion: The results of this study showed that based on the bleeding components in gastric bypass surgery patients, propranolol may be useful for reducing bleeding parameters in gastric bypass surgery.