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British Journal of Anaesthesia 2008 101(4):439-441; doi:10.1093/bja/aen247
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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

Calcium channel blockers, beta-blockers, and perioperative cardiovascular stability

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It is contentious whether calcium channel blockers as a group offer any cardioprotection in the perioperative period for patients undergoing non-cardiac surgery. Meta-analyses of the cardioprotective efficacy of calcium channel blockers have resulted in conflicting results, with one meta-analysis having a sample size too small to draw any conclusions,1 and the other showing significantly reduced myocardial ischaemia and a significantly reduced composite of death, myocardial infarction, or congestive heart failure.2 However, of all the studies identified, only a single study of 50 patients specifically examined dihydropyridines.3

Dihydropyridines have properties which are theoretically hazardous in the perioperative period for patients undergoing major non-cardiac surgery. Of particular concern in the perioperative period is that the vasodilation produced by dihydropyridines causes reflex adrenergic activation producing an . . . [Full Text of this Article]

B. M. Biccard1,* and S. J. Howell2

1 Department of Anaesthetics
Nelson R. Mandela School of Medicine
Private Bag 7
Congella
Kwazulu-Natal 4013
South Africa
2 University of Leeds
Leeds General Infirmary
Great George Street
Leeds LS1 3EX
UK

* E-mail: bruce.biccard@nda.ox.ac.uk


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