Preoperative beta-blockade for patients undergoing craniotomy: a comparison between propranolol and atenolol

This study was undertaken to establish if beta-blocking drugs given orally before surgery could reduce the pressor responses to laryngeal instrumentation and tracheal intubation in neurosurgical patients. Forty-two neurosurgical patients undergoing craniotomy were randomized into three groups. Groups 1 and 2 received atenolol (100 mg) and propranolol (80 mg) respectively. Group 3 were controls and given no beta-blockers. A standard anaesthetic technique was used and blood pressure and heart rate were measured continuously from induction of anaesthesia until five minutes after tracheal intubation. There were increases in both heart rate and systolic blood pressure in all three groups but the rises in the treated groups were significantly less than in the control group (P less than 0.01). There were no significant differences in the haemodynamic responses between the propranolol and atenolol treated patients.