Thirty six patients undergoing posterior lumbar internal fixation surgery were randomized to receive a continuous intraoperative infusion of esmolol at 5 μg/kg/min (E5, n=18) or esmolol at 10 μg/kg/min (E10, n=18). The primary outcome of interest was intraoperative blood loss. Secondary outcomes of interest were to determine the impact of esmolol on intraoperative hemodynamic parameter, postoperative patient-controlled analgesia (PCA) and pain scores. The E10 group demonstrated significantly less intraoperative blood loss compared to the E5 group with no differences in intraoperative hemodynamic parameters. The E10 group also demonstrated significantly lower pain scores immediately postoperatively and reduced PCA consumption at 8, 24, and 48 hours postoperatively.