Comparing the effect of dexmedetomidine and metoprolol in reducing blood loss during craniotomies due to severe cerebral blunt trauma

Introduction: To control and reduce blood loss during craniotomy is one of the most important and significant goals of anesthesiologists and neurosurgeons. Numerous drugs including beta-blockers, calcium channel blockers, alpha-agonists, and narcotics have been used to achieve this goal. We compared the effects of dexmedetomidine and metoprolol in reducing blood loss during craniotomy due to severe cerebral blunt trauma. Methodology: It was a randomized, double-blind clinical trial. Forty-four craniotomy candidates with severe head injuries were randomly divided into dexmedetomidine and metoprolol groups. For all groups, a questionnaire was completed so that data on MAP, pulse rate, mean blood loss score, mean number of packed cell units received, events of hypotension and bradycardia and the survival of the patients was recorded. Using SPSS-21 statistical software, the data obtained from the questionnaires were statistically inferred by the T-test and ANOVA test, and the results are expressed in tables and figures. Results: There was no significant difference in age and sex frequency in this study (p = 0.6). There was a significant difference between the two groups in terms of blood loss after the start of surgery, so that the average blood loss in patients at 15, 30, 45, 60, 90, 120 min after the start of the surgery in the dexmedetomidine group was less than in the metoprolol group (p < 0.05). Conclusion: Dexmedetomidine and metoprolol could reduce blood loss during surgery and provide controlled hypotension during craniotomies due to severe cerebral blunt trauma. The effect is more pronounced with the use of dexmedetomidine compared to metoprolol. Key words: Dexmedetomidine; Metoprolol; Craniotomy; Head trauma; Hypotension Citation: Kamali A, Rahimifar R, Zargar S, Rafie AN. Comparing the effect of dexmedetomidine and metoprolol in reducing blood loss during craniotomies due to severe cerebral blunt trauma. Anaesth. pain intensive care 2021;25(6):752–756 ; DOI: 10.35975/apic.v25i6.1698 Received: November 26, 2020, Reviewed November 03, 2021, Accepted: November 03, 2021