Abstract
PURPOSE OF REVIEW: Perioperative β-blockade has been advocated by multiple authors and recent guidelines as a strategy to reduce cardiac risk in noncardiac surgery. Knowledge about application of this treatment modality to the ambulatory surgery population is poor. RECENT FINDINGS: Although the initial trial in patients with a positive stress test undergoing major vascular surgery demonstrated significantly fewer perioperative cardiac events among those randomized to perioperative β-blocker therapy, more recent studies in patients without documented coronary artery disease undergoing major noncardiac surgical procedures were unable to demonstrate efficacy. Guidelines from the American Heart Association/American College of Cardiology have been reported and advocated class I recommendations for perioperative β-blockade only for patients previously taking β-blockers and those patients with a positive stress test undergoing vascular surgery. There was insufficient evidence to make a recommendation in low-risk surgery. SUMMARY: Based upon the available evidence and guidelines, patients currently taking β-blockers and undergoing ambulatory surgery should continue these agents and protocols employing this strategy should be beneficial. In patients who are not currently taking β-blockers and in whom long-term therapy is not warranted, current evidence does not support instituting prophylactic therapy in the ambulatory surgery population.
Original language | English (US) |
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Pages (from-to) | 526-530 |
Number of pages | 5 |
Journal | Current Opinion in Anaesthesiology |
Volume | 20 |
Issue number | 6 |
DOIs | |
State | Published - Dec 2007 |
Externally published | Yes |
Keywords
- Guidelines
- Myocardial infarction
- Myocardial ischemia
- β-adrenergic blockade
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine