September 24, 2010AnesthesiologyOpen Access

Challenges of β-Blockade in Surgical Patients

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Why the study?

Does the addition or continuation of perioperative beta-blockade improve survival in at-risk surgical patients?

Population

38,779 operations over 12 years in surgical patients with proven coronary artery disease, previous or…

Comparison

Addition or continuation of perioperative… vs Absence of beta-blockade.

Design

Editorial

Follow-up

30 days and 1 year

Authors

PFPierre FoëxUniversity of the Sciences JSJohn W. SearSprint (United States)

Discussion

Member takes

Implication

This editorial emphasizes that in at-risk noncardiac surgical patients, maintaining or carefully initiating perioperative beta-blockade improves survival, whereas withdrawing it is dangerous.

Structured PICO

Does the addition or continuation of perioperative beta-blockade improve survival in at-risk surgical patients?

Population

38,779 operations over 12 years in surgical patients with proven coronary artery disease, previous or current vascular surgery, or two of the following risk factors: diabetes mellitus, hypertension, age older than 60 years, smoking, or hyperlipidemia.

Intervention

Addition or continuation of perioperative beta-blockade (started the day of surgery or maintained from prior therapy).

Comparator

Absence of beta-blockade (either through nonadministration as a result of clinician's choice or active drug withdrawal).

Outcome

Survival/mortality at 30 days and 1 year.hard clinical

This editorial emphasizes that in at-risk noncardiac surgical patients, maintaining or carefully initiating perioperative beta-blockade improves survival, whereas withdrawing it is dangerous.

Limitations

Data collected in a single department known for its interest in myocardial ischemia and cardiac protection
Potential confounding by concurrent therapies such as statins and clonidine
Observational design with inherent limitations compared to randomized controlled trials

Cite This Study

Foëx et al. (2010) studied this question.

synapsesocial.com/papers/6a81579d176d2ce03166185f https://doi.org/10.1097/aln.0b013e3181f1c07e

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Implication

This editorial emphasizes that in at-risk noncardiac surgical patients, maintaining or carefully initiating perioperative beta-blockade improves survival, whereas withdrawing it is dangerous.

Challenges of β-Blockade in Surgical Patients

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Challenges of β-Blockade in Surgical Patients

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider