Comparative Evaluation of Clonidine and Metoprolol for Perioperative Hemodynamic Stability, Blood Loss Control, and Postoperative Recovery in Patients Undergoing Elective Surgery: A Prospective Randomized Controlled Study

Authors: Baseeha Sereen V.A, Swadika Natarajan, Balasubramanian Arunkumar, Shanu Shanmugasundaram, PANNEERSELVAM PERIASAMY, Arbind Kumar Choudhary

DOI: 10.18231/j.ijca.10098.1758886969

Keywords: Keywords: Clonidine; Metoprolol; perioperative care; hemodynamic stability; blood loss; postoperative recovery; elective surgery.

Abstract: Abstract Background: Effective perioperative management of hemodynamics and blood loss is critical to patient safety and recovery in elective surgeries. Clonidine, an α2 adrenergic agonist, and Metoprolol, a selective β1 adrenergic antagonist, are commonly used to maintain hemodynamic stability during surgery. This study compares the efficacy of Clonidine and Metoprolol in providing perioperative stability, minimizing intraoperative blood loss, and optimizing postoperative recovery outcomes. Methods: This prospective, randomized controlled study included 60 patients (ASA I and II, aged 18-60) scheduled for elective surgery under general anesthesia at Vinayaka Mission’s Kirupananda Variyar Medical College & Hospital, Salem. Patients were randomized into two groups: Group A (Clonidine 0.15 mg, n=30) and Group B (Metoprolol 50 mg, n=30). Hemodynamic parameters, including heart rate, systolic and diastolic blood pressure, respiratory rate, and oxygen saturation, were monitored throughout surgery. Blood loss was measured using hemoglobin concentration in the suction canister, while the quality of the surgical field was graded by the Average Category Scale (ACS). Postoperative outcomes, including recovery time, pain score, incidence of nausea, and hospital stay, were recorded. Data were analyzed using the Kruskal-Wallis chi-square and Yate’s chi-square tests. Results: Both Clonidine and Metoprolol effectively maintained intraoperative hemodynamic stability, with no statistically significant differences in heart rate, blood pressure, or oxygen saturation between groups (P > 0.05). Clonidine showed a significant advantage in reducing intraoperative blood loss compared to Metoprolol (P = 0.0002), likely due to its sympatholytic effects, resulting in lower suction volume and better surgical field quality. Coefficients of variation for heart rate and blood pressure indicated minimal hemodynamic variability in both groups, supporting the reliability of each drug. Postoperative recovery outcomes, including pain scores, nausea incidence, recovery time, and length of hospital stay, were comparable between the two groups (P > 0.05), indicating similar recovery profiles. Conclusion: Both Clonidine and Metoprolol provide effective perioperative hemodynamic stability and comparable postoperative recovery outcomes, with Clonidine demonstrating a potential benefit in blood loss reduction. The findings suggest that Clonidine may be advantageous in surgeries where blood conservation is crucial, while both agents are suitable for maintaining stable intraoperative parameters. This study supports the safe and flexible use of Clonidine and Metoprolol in elective surgeries, with further research recommended to refine patient-specific drug selection in perioperative management.