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Beta-receptor blocker withdrawal. A preoperative problem in general surgery?
Acta Anaesthesiologica Scandinavica. Supplementum
|January 1, 1982
Summary
Withdrawing beta-receptor blockers before surgery may be dangerous. Patients experienced increased heart rate, blood pressure, and chest pain, with some surgeries postponed due to withdrawal symptoms.
Area of Science:
- Cardiology
- Anesthesiology
- Pharmacology
Background:
- Beta-receptor blockers are commonly prescribed for ischemic heart disease and hypertension.
- Long-term use of these medications necessitates careful consideration before surgical procedures.
Purpose of the Study:
- To investigate the effects of preoperative beta-receptor blockade withdrawal on cardiovascular parameters and patient outcomes.
- To assess the safety of a 4-day preoperative withdrawal regimen for patients on chronic beta-blocker therapy.
Main Methods:
- A prospective randomized study involving 91 patients undergoing general surgery.
- Patients were divided into two groups: gradual withdrawal of beta-blockers (n=51) or continuation until surgery (n=48).
- Monitored arterial blood pressure, heart rate, rate-pressure product, and incidence of chest pain.
Main Results:
- Beta-blocker withdrawal led to significant increases in heart rate, rate-pressure product, and blood pressure in hypertensive patients.
- Nine patients who had beta-blockers withdrawn experienced increased chest pain, compared to none in the continued therapy group.
- Four surgeries were postponed due to severe withdrawal symptoms.
Conclusions:
- A 4-day preoperative withdrawal of long-term beta-receptor blockade is potentially hazardous for patients with ischemic heart disease and/or hypertension.
- Continuing beta-receptor blockade until surgery appears to be a safer approach in this patient population.