NDLI: Cardioprotective effects of perioperative ß-blockade in vascular surgery patients: fact or fiction?

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Cardioprotective effects of perioperative ß-blockade in vascular surgery patients: fact or fiction?

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Cardioprotective effects of perioperative ß-blockade in vascular surgery patients: fact or fiction?

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Flier, Suzanne Buhre, Wolfgang F. Van Klei, Wilton A.
Description	Country affiliation: Netherlands Author Affiliation: Flier S ( Division of Perioperative Care and Emergency Medicine, Department of Anesthesiology, University Medical Center Utrecht, Utrecht, The Netherlands.)
Abstract	PURPOSE OF REVIEW: Perioperative ß-blockade remains a subject of debate. In this review, recent literature and current guidelines for perioperative ß-blockade in vascular surgery patients are discussed. RECENT FINDINGS: Available evidence suggests that perioperative ß-blockade may be beneficial in reducing cardiac events. However, in a recent large study, the incidences of stroke and mortality were increased in patients on perioperative ß-blockers. Large systematic reviews failed to demonstrate a net beneficial effect of perioperative ß-blockers. The 2009 American and the European guidelines for perioperative ß-blockade in vascular surgery disagree on the available evidence but do recommend ß-blockade for several indications. Most recent, Wallace and colleagues published a large-sized retrospective study, reporting a beneficial effect of the adoption of a protocol for perioperative ß-blockade. SUMMARY: Perioperative ß-blockade reduces cardiac events, but at the expense of increased risk for mortality and stroke. The guidelines seem to be eager to follow positive outcome studies, without considering the effects of ß-blockade on other organ systems. Perhaps the main reason for the reported cardioprotective effects of perioperative ß-blocker therapy should be sought in failing preoperative ß-blocker prophylaxis (irrespective of surgery).
File Format	HTM / HTML
ISSN	09527907
Issue Number	1
Volume Number	24
e-ISSN	14736500
Journal	Current Opinion in Anaesthesiology
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2011-02-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Anesthesiology Adrenergic Beta-antagonists Therapeutic Use Perioperative Care Vascular Surgical Procedures Methods Humans Meta-analysis As Topic Metoprolol Myocardial Infarction Physiopathology Practice Guidelines As Topic Journal Article Research Support, Non-u.s. Gov't Review
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine

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