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British Journal of Anaesthesia 2008 101(2):135-138; doi:10.1093/bja/aen194
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Perioperative beta-blockade, 2008: What does POISE tell us, and was our earlier caution justified?

The first 150 words of the full text of this article appear below.

In the early days of patients presenting for surgery while on beta-blockers, it was customary to stop their administration 2 weeks before elective surgery because of the perceived risk of cardiovascular collapse that could result from blockade of compensatory mechanisms. This view was supported by mostly anecdotal evidence,1 and seemed illogical as surgery constitutes a high stress situation during which the heart may need to be protected by blockade from the effects of exaggerated sympathetic activity. In 1973, the first detailed haemodynamic study of beta-blockade in surgical patients showed that beta-blockade was compatible with anaesthesia and surgery, reduced the risk of hypertension on laryngoscopy and intubation, and decreased the incidence of both ventricular arrhythmias and myocardial ischaemia.2

. . . [Full Text of this Article]

Is it possible to obtain benefit from perioperative beta-blockade and at the same time avoid the risks?

What are the take home messages with regard to perioperative beta-blockade after POISE?

Declaration of interest

Appendix

J. W. Sear*, J. W. Giles, G. Howard-Alpe and P. Foëx

Nuffield Department of Anaesthetics
University of Oxford
John Radcliffe Hospital
Headley Way
Oxford OX3 9DU
UK

* E-mail: john.sear@nda.ox.ac.uk


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E-letters:

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A long-term follow-up is necessary to assess the burden of myocardial ischaemia
Sylvain Ausset, et al.
British Journal of Anaesthesia, 20 Jul 2008 [Full text]
Three actors on the stage: Myocardial ischemia, beta-blocking agents and hypotension
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Response to the poise Study
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