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Is the Perioperative Use of  -Blockers Still Recommended? A Critical Review of Recent Controversies
Damian Domanski, MD, PhD
and
Ernst R. Schwarz, MD, PhD*
Cedars Sinai Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA
* To whom correspondence should be addressed. E-mail: ernst.schwarz{at}cshs.org.
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Abstract |
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The optimal role of  -adrenergic receptor blockade in the perioperative period remains unclear in patients at risk for cardiovascular events. Cardiovascular complications continue to be the most common cause of perioperative morbidity and mortality, and cardioprotective properties of -blockers are widely recognized, yet the results of the clinical trials investigating the use of different -blockers in the perioperative period are controversial. The discrepancy might be related to differences in the design of studies, use of different agents, administration by different routes, and continuation for different time intervals. Evidently, perioperative mortality and morbidity seem to be related to heart rate, and the majority of complications are related to -blockers' side effects. Based on the observations from different studies, we propose an algorithm for perioperative blockade.
First published on September 4, 2009, doi:10.1177/1074248409343934
Journal of Cardiovascular Pharmacology and Therapeutics 2009;14:258.
A more recent version of this article appeared on December 1, 2009
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