BETA-BLOCKERS IN ERAS: MODULATING THE ADRENERGIC SURGE AND METABOLIC STRESS FOR OPTIMIZED RECOVERY

Background: Enhanced Recovery After Surgery (ERAS) protocols seek to optimize recovery and minimize postoperative complications by alleviating surgical strain and facilitating swift recuperation. The adrenergic physiologic response to surgical trauma continues to be an issue even with standardized perioperative care. Within these ERAS constructs, beta-blockers appear to be useful for blunting this stress response and provide additional advantages. To evaluate the effectiveness of perioperative beta-blockers in controlling the adrenergic and metabolic stress response in patients undergoing major elective surgeries under ERAS protocols, and to assess their impact on recovery outcomes. Methods: A randomized controlled trial was performed at Ayub Medical College from January 2022 to January 2023 with a sample size of 89 adult subjects who were scheduled to undergo major elective surgical procedures. Patients were divided into two groups: one received beta-blockers coupled with Enhanced Recovery after Surgery (ERAS) protocols while the other received ERAS only. The hemodynamic metrics, metabolic parameters, pain scores, opioid usage, duration of hospital stay, and complication rates were all documented and analyzed using relevant statistical methodologies. Results: The beta-blocker group demonstrated significantly lower intraoperative heart rate and blood pressure. Postoperatively, this group had reduced pain scores, lower opioid requirements, fewer complications, and shorter hospital stays compared to the standard ERAS group (p < 0.05 for all). No significant differences were observed in ICU admissions or 30-day readmissions. Conclusion: The addition of beta-blockers to ERAS protocols appears to be a safe and effective strategy to modulate physiological stress responses and promote faster recovery. Their role in surgical care should be further explored in broader patient populations.