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Successful implementation of perioperative beta-blockade utilizing a multidisciplinary approach
Samuel Armanious1, David T Wong, Edward Etchells
1Department of Anesthesiology, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada.
Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|February 1, 2003
Summary
This study successfully implemented a perioperative beta-blockade protocol for patients with coronary artery disease (CAD) undergoing non-cardiac surgery. The strategy showed few side effects and low rates of postoperative cardiac events.
Area of Science:
- Cardiology
- Anesthesiology
- Internal Medicine
Background:
- Coronary artery disease (CAD) poses significant risks for patients undergoing major non-cardiac surgery.
- Perioperative beta-blockade is a strategy to mitigate these cardiac risks.
- Effective implementation requires multidisciplinary collaboration.
Purpose of the Study:
- To describe the implementation of a perioperative beta-blockade protocol.
- To evaluate the protocol in patients with or at risk of coronary artery disease (CAD).
- To present the outcomes and safety of this perioperative management strategy.
Main Methods:
- A protocol for perioperative beta-blockade was developed and implemented.
- Patients with surgical and medical indications for beta-blockade were identified preoperatively.
- Outpatient initiation of beta-blockers, intraoperative anesthetic management, and postanesthesia care unit (PACU) protocols were utilized.
Main Results:
- Sixty-nine patients received perioperative beta-blockade.
- Preoperative beta-blockers included metoprolol, atenolol, and propranolol.
- Postoperative cardiac events occurred in only 4.3% of patients, with minimal adverse effects.
Conclusions:
- Successful implementation of a perioperative beta-blockade strategy was achieved through collaboration.
- The protocol demonstrated a low incidence of side effects and cardiac morbidities.
- This approach is effective for managing patients with cardiac risks undergoing major non-cardiac surgery.