Preoperative Ivabradine Doses for Hemodynamic Stability in FESS

This is a prospective, randomized, double‐blind, placebo‐controlled, parallel‐group trialconducted at Minia University Hospital. Eighty‐four patients aged 21‐60 years, ASAphysical status I or II, scheduled for functional endoscopic sinus surgery (FESS) undergeneral anesthesia, with a baseline heart rate of 70 beats per minute or higher in sinusrhythm, will be randomly allocated into three equal groups. Group A will receiveivabradine 5 mg the night before surgery plus 5 mg on the morning of surgery; Group Bwill receive ivabradine 5 mg the night before plus 7.5 mg on the morning of surgery;Group C will receive a placebo (folic acid) on both occasions. Randomization codes willbe concealed in sequentially numbered opaque sealed envelopes, and study medication willbe prepared by an independent pharmacist to maintain blinding. Hemodynamic parameterswill be recorded at standardized time points throughout the perioperative period.Surgical field visibility will be assessed using the Boezaart Bleeding Scale, andrecovery will be assessed using the modified Aldrete Score. The study aims to determinewhich ivabradine regimen provides superior hemodynamic stability and surgical fieldconditions during FESS.