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[Perioperative beta-blockers. Part two: therapeutic indications]
V Piriou1, A Aouifi, J J Lehot
1Service d'Anesthésie-Réanimation, Hôpital CArdiovasculaire & Pneumologique L. Pradel, Lyon, France.
Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|August 10, 2000
Summary
Beta-blockers (BB) improve outcomes for patients undergoing surgery, especially those with cardiovascular disease. Their use is encouraged in perioperative medicine for better patient results.
Area of Science:
- Cardiovascular Pharmacology
- Perioperative Medicine
- Anesthesiology
Context:
- Perioperative medicine requires understanding beta-blocker (BB) pharmacology and pathophysiology.
- Evidence supports BB use in various surgical and cardiac conditions.
Purpose:
- To review essential pharmacologic and pathophysiologic information for prescribing beta-blockers in perioperative settings.
- To consolidate evidence on the benefits of beta-blockers in surgical patients.
Summary:
- Studies since 1979 demonstrate BB benefits in non-cardiac surgery for hypertensive patients.
- Atenolol showed reduced postoperative ischemia and mortality in coronary artery disease patients (1996).
- Preoperative BB treatment is beneficial in coronary surgery (since 1983) and for acute myocardial infarction or chronic heart failure (excluding NYHA class IV).
Impact:
- Beta-blockers improve postoperative outcomes in patients with cardiovascular disease or risk factors.
- Widespread adoption of BB in perioperative care is recommended.
- Enhanced patient recovery and reduced mortality are key benefits.