Inclusion Criteria:  GCS preoperative >10 Abbreviated Injury Scale (AIS) >3 Length stay in ICU >48 h  Exclusion Criteria:  Hypersensitivity to propranolol Asthmatic patient COPD History of smoking Any cardiac problems eg: ( heart failure or HB ) pheochromocytoma Pregnant patient Length stay <48h Death within 48 h of admission Patient who previously received any beta blocker at home. Symptomatic Bradycardia <60 b/m (sick sinus syndrome) Hemodynamic unstable patients