Subject Area


Article Type

Original Study



Bleeding during endoscopic nasal surgeries impairs operative visibility, prolongs surgery, increases complications, and requires controlled hypotensive anesthesia.


To compare the efficacy and safety of oral labetalol versus oral metoprolol as an adjuvant to controlled hypotensive anesthesia during endoscopic nasal surgery.

Patients and methods

This was a randomized (1 : 1), parallel, double-blind, phase four clinical trial; carried out on 60 patients, who were candidates for endoscopic nasal surgeries under general anesthesia at Damanhour Teaching Hospital, El-Beheira, Egypt, between April 2021 and October 2022. Patients were randomly allocated into two equal groups; group L, received oral labetalol, and group M, received oral metoprolol.


The volume and rate of intraoperative blood loss were significantly lower in group L (90.73±3.034 ml, 1.276±0.136 ml/min) than in group M (107.30±2.677 ml, 1.409±0.106 ml/min, P


Oral premedication with labetalol is more effective than metoprolol for controlled hypotensive anesthesia during endoscopic nasal surgeries. It decreases intraoperative blood loss and is associated with lower anesthetic consumption, better surgical field quality, higher surgeon satisfaction, and with controllable side effects.