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March 13, 2018Cochrane library

Perioperative beta-blockers for preventing surgery-related mortality and morbidity

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Key result

Perioperative beta-blockers were evaluated in a systematic review of 88 randomized controlled trials involving 19,161 participants, though specific efficacy results were truncated in the provided text.

Why the study?

Do perioperatively administered beta-blockers reduce surgery-related mortality and morbidity in patients undergoing surgery under general anaesthesia?

Population

19,161 patients from 88 randomized controlled trials undergoing any type of surgery with all or a…

Comparison

Perioperatively administered beta-blockers vs Standard care or placebo

Design

Meta-analysis

Authors

HBHermann BlessbergerElectrophysiologyJKJuergen KammlerJohannes Kepler University of LinzHDHans DomanovitsMedical University of Vienna

Discussion

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Implication

Raises mortality and stroke risk in non-cardiac surgery; challenges routine use and supports surgery-type-specific recommendations.

Study Design

Type

Systematic Review (n=19,161)

Structured PICO

Do perioperatively administered beta-blockers reduce surgery-related mortality and morbidity in patients undergoing surgery under general anaesthesia?

P
Population
19,161 patients from 88 randomized controlled trials undergoing any type of surgery (cardiac and non-cardiac) with all or a significant proportion of participants under general anaesthesia.
I
Intervention
Perioperatively administered beta-blockers
C
Comparator
Standard care or placebo
O
Outcome
Surgery-related mortality and morbidity (including all-cause mortality, acute myocardial infarction, myocardial ischaemia, cerebrovascular events, hypotension, bradycardia, congestive heart failure, arrhythmias, and length of hospital stay)hard clinical

Perioperative beta-blockers reduce arrhythmias in cardiac surgery but increase mortality and stroke risk in non-cardiac surgery, offsetting their benefits in reducing myocardial infarction.

Limitations

  • Only six studies (7%) met the highest methodological quality criteria with an overall low risk of bias.
  • Only 6 of 88 studies (7%) met the highest methodological quality criteria (low risk of bias)
  • Quality of evidence was low to moderate for several key outcomes

Cite This Study

Blessberger et al. (2018) conducted a systematic review in Surgery under general anaesthesia (n=19,161). Perioperative beta-blockers vs. Standard care or placebo was evaluated on Surgery-related mortality and morbidity. Perioperative beta-blockers were evaluated in a systematic review of 88 randomized controlled trials involving 19,161 participants, though specific efficacy results were truncated in the provided text.

synapsesocial.com/papers/6a1908c6a6ebdba58ad31918https://doi.org/10.1002/14651858.cd004476.pub3
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Perioperative use of a beta blocker in coronary artery bypass grafting2013 · 26 citations
  2. 2Efficacy and safety of timolol for prevention of supraventricular tachyarrhythmias after coronary artery bypass surgery.1984 · 170 citations
  3. 3Efficacy and safety of low-dose propranolol versus diltiazem in the prophylaxis of supraventricular tachyarrhythmia after coronary artery bypass grafting1996 · 43 citations
  4. 4Oral Sotalol Reduces the Incidence of Atrial Fibrillation after Coronary Artery Bypass Surgery1993 · 111 citations
  5. 5Supraventricular Tachyarrhythmias After Coronary Bypass Surgery - A Double Blind Randomized Trial of Prophylactic Low Dose Propranolol1988 · 42 citations