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British Journal of Anaesthesia, 2001, Vol. 86, No. 2 161-164
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Editorial

Editorial I

Peri-operative ß-blockade: a useful treatment that should be greeted with cautious enthusiasm

S. J. Howell, J. W. Sear and P. Foex

Over the past decade, there have been several reports on the use of peri-operative ß-adrenoceptor blockade to reduce peak heart rates in response to noxious stimuli or to myocardial ischaemia in patients with arterial hypertension or coronary artery disease.1–4 Indeed even our sister journal (the British Journal of Surgery) has recently published a leading article advocating the widespread use of ß-adrenoceptor blockade in all older patients undergoing abdominal surgery, as well as in all patients undergoing vascular surgery.5 But does the available evidence really support such a stance?

It is proposed that the sympatholytic effects of ß-blockade may reduce the incidence of peri-operative cardiac complications. This is certainly plausible. If we believe that peri-operative cardiac events are a result of a supply– demand imbalance in the delivery of oxygen to the myocardium, then any reductions in heart rate and blood pressure produced by ß-blockers may minimize such imbalance. A . . . [Full Text of this Article]

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