TY - JOUR
T1 - Perioperative β-blocker therapy and heart rate control during noncardiac surgery
AU - Berg, Carolyn
AU - Berger, David H.
AU - Makia, Ayuk
AU - Whalen, Caleb
AU - Albo, Daniel
AU - Bellows, Charles
AU - Awad, Samir S.
PY - 2007/8/1
Y1 - 2007/8/1
N2 - Background: Perioperative treatment with β-blockade is a widely advocated practice. We assessed the preoperative, intraoperative, and postoperative control of heart rate (HR) in patients who received β-blockade as recommended during preoperative medicine clearance. Methods: We conducted a retrospective review of patients who underwent noncardiac surgery from 2002 to 2004 at the Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas, with recommendations of β-blockade as part of their risk stratification. Demographic data and comorbid risk factors were collected on patients undergoing general anesthesia. All data were presented as mean ± SEM. The chi-square test and analysis of variance were used for statistical analysis. Results: A total of 130 patients referred for preoperative medicine clearance, who were risk-stratified based on comorbid conditions and risk of procedure, had β-blockade started before elective surgery. Sixty percent (78 of 130) of the patients underwent high-/intermediate-risk surgery. The mean preoperative HR was 74 ± 1 beat per minute (bpm). The mean intraoperative HR was 69 ± 1 bpm. The mean postoperative HR was 84 ± 1 bpm. There was a significant difference in the preoperative and intraoperative HR when compared with the postoperative HR (P < .003). There were no deaths at 30 days postoperatively. Perioperative cardiac morbidity occurred in 5.4% (7 of 130) of all patients (high patient risk, 71%; low patient risk, 29%; P < .05), and did not correlate with procedure risk. Conclusions: β-blockade is achieved sufficiently in the preoperative and intraoperative settings. However, attention to postoperative HR may be warranted to maintain the benefits of β-blockade.
AB - Background: Perioperative treatment with β-blockade is a widely advocated practice. We assessed the preoperative, intraoperative, and postoperative control of heart rate (HR) in patients who received β-blockade as recommended during preoperative medicine clearance. Methods: We conducted a retrospective review of patients who underwent noncardiac surgery from 2002 to 2004 at the Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas, with recommendations of β-blockade as part of their risk stratification. Demographic data and comorbid risk factors were collected on patients undergoing general anesthesia. All data were presented as mean ± SEM. The chi-square test and analysis of variance were used for statistical analysis. Results: A total of 130 patients referred for preoperative medicine clearance, who were risk-stratified based on comorbid conditions and risk of procedure, had β-blockade started before elective surgery. Sixty percent (78 of 130) of the patients underwent high-/intermediate-risk surgery. The mean preoperative HR was 74 ± 1 beat per minute (bpm). The mean intraoperative HR was 69 ± 1 bpm. The mean postoperative HR was 84 ± 1 bpm. There was a significant difference in the preoperative and intraoperative HR when compared with the postoperative HR (P < .003). There were no deaths at 30 days postoperatively. Perioperative cardiac morbidity occurred in 5.4% (7 of 130) of all patients (high patient risk, 71%; low patient risk, 29%; P < .05), and did not correlate with procedure risk. Conclusions: β-blockade is achieved sufficiently in the preoperative and intraoperative settings. However, attention to postoperative HR may be warranted to maintain the benefits of β-blockade.
KW - Cardioprotective
KW - Heart rate
KW - Perioperative β-blockade
KW - Surgical β-blockade
UR - http://www.scopus.com/inward/record.url?scp=34347229012&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34347229012&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2006.08.090
DO - 10.1016/j.amjsurg.2006.08.090
M3 - Article
C2 - 17618802
AN - SCOPUS:34347229012
SN - 0002-9610
VL - 194
SP - 189
EP - 191
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 2
ER -