Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Antihypertensive Drugs: Types of β-Blockers01:28

Antihypertensive Drugs: Types of β-Blockers

1.9K
β receptors are classified into three subclasses: β1, β2, and β3. β1 receptors are primarily located in the heart and kidneys. When they get activated, they increase heart rate, contractility, and renin release. This process enhances blood pressure and aids in stress management. In contrast, β2 receptors are situated mainly in the lungs, blood vessels, and skeletal muscles. Upon activation, they trigger smooth muscle relaxation, causing bronchodilation and...
1.9K
Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers01:27

Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers

1.9K
β-receptor blockers significantly impact the cardiovascular system by counteracting catecholamine-induced sympathetic responses. These medications decrease heart rate, contractility, and cardiac output, potentially leading to cardiac depression, life-threatening bradycardia, and death. Therapeutically, β-blockers function as mild antihypertensives and are utilized in treating angina pectoris and cardiac arrhythmias. However, nonselective β-blockers inhibit β2-receptors in...
1.9K
Adrenergic Antagonists: ɑ and β-Receptor Blockers01:31

Adrenergic Antagonists: ɑ and β-Receptor Blockers

1.4K
Third-generation β-blockers, such as labetalol and carvedilol, represent a significant advancement in managing cardiovascular conditions. Unlike conventional β-blockers, which can induce peripheral vasoconstriction, third-generation drugs block α1 adrenoceptors. This promotes vasodilation through several mechanisms, such as increased nitric oxide production, inhibition of calcium ion entry, opening of potassium ion channels, and antioxidant action. Labetalol, for instance, is...
1.4K
Depolarizing Blockers: Pharmocokinetics01:19

Depolarizing Blockers: Pharmocokinetics

715
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
715
Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

1.1K
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
1.1K
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

424
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
424

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Effect of a liberal fluid fasting policy before surgery on the incidence of aspiration: a single centre retrospective observational study.

BJA open·2026
Same author

ETHER: a proposal for a European peri-operative data sharing and registry network.

European journal of anaesthesiology·2026
Same author

Risk of periprocedural regurgitation of gastric contents in patients on glucagon-like peptide-1 receptor agonists: a two-centre nested case-control study.

British journal of anaesthesia·2026
Same author

Cerebrovascular regulation during increases in systemic blood flow and systemic vascular resistance.

Journal of applied physiology (Bethesda, Md. : 1985)·2025
Same author

The association between postoperative myocardial injury of unexplained aetiology after noncardiac surgery and sex and cancer on 1-yr survival: a retrospective, single-centre, observational cohort study.

BJA open·2025
Same author

Proactive vs Reactive Treatment of Hypotension During Surgery: The PRETREAT Randomized Clinical Trial.

JAMA·2025

Related Experiment Video

Updated: Mar 27, 2026

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
05:39

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia

Published on: May 26, 2023

2.6K

[Which is the preferred perioperative beta-blocker?].

Wilton A van Klei1

  • 1UMC Utrecht, Divisie Vitale Functies, afdeling Anesthesiologie, Utrecht.

Nederlands Tijdschrift Voor Geneeskunde
|January 7, 2016
PubMed
Summary

For patients undergoing non-cardiac surgery, initiating beta-blocker therapy is recommended. However, avoid continuing metoprolol due to increased cardiovascular mortality risk; opt for atenolol or bisoprolol instead.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Current guidelines recommend beta-blocker initiation and continuation for at-risk patients undergoing non-cardiac surgery.
  • Recent studies indicate a potential increased risk of perioperative cardiovascular mortality with continued beta-blockade, particularly with metoprolol.

Purpose of the Study:

  • To evaluate the differential effects of various beta-blockers in the perioperative setting.
  • To provide evidence-based recommendations for perioperative beta-blocker selection.

Main Methods:

  • Review of recent literature on perioperative cardiovascular outcomes associated with different beta-blockers.
  • Analysis of pharmacodynamic and pharmacokinetic properties of metoprolol, atenolol, and bisoprolol.

Main Results:

More Related Videos

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
09:12

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery

Published on: March 27, 2018

10.0K
Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation
08:56

Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation

Published on: September 24, 2021

3.2K

Related Experiment Videos

Last Updated: Mar 27, 2026

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
05:39

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia

Published on: May 26, 2023

2.6K
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
09:12

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery

Published on: March 27, 2018

10.0K
Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation
08:56

Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation

Published on: September 24, 2021

3.2K
  • Metoprolol exhibits lower beta1 receptor affinity and is metabolized by CYP2D6, leading to variable plasma concentrations.
  • These properties may contribute to the observed increased cardiovascular mortality risk in patients continuing metoprolol therapy.
  • Atenolol and bisoprolol demonstrate higher beta1 receptor affinity and potentially safer perioperative profiles.

Conclusions:

  • Initiate perioperative beta-blocker therapy with atenolol or bisoprolol, aligning with European guidelines.
  • Discontinue or carefully reconsider the use of metoprolol in the perioperative period for non-cardiac surgery due to safety concerns.