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January 13, 2015Cochrane libraryOpen Access

Beta-adrenergic blockers for perioperative cardiac risk reduction in people undergoing vascular surgery

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Why the study?

Does perioperative beta-adrenergic blockade reduce cardiac morbidity and mortality in adults undergoing major non-cardiac vascular surgery?

Population

599 adults (over 18 years of age) undergoing major non-cardiac vascular surgery (pooled from 2 RCTs)

Comparison

Perioperative beta-adrenergic blockade vs Placebo

Design

Meta-analysis, randomised controlled trials, double-blind

Authors

KMKatayoun MostafaieTorrance Memorial Medical CenterRBRachel BedenisUniversity of EdinburghDHDarrell W. HarringtonApple (Israel)

Discussion

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Member takes

Overview

Avoid routine perioperative beta-blockade in vascular surgery; confirms no event reduction in Level 1 evidence.

Structured PICO

Does perioperative beta-adrenergic blockade reduce cardiac morbidity and mortality in adults undergoing major non-cardiac vascular surgery?

P
Population
599 adults (over 18 years of age) undergoing major non-cardiac vascular surgery (pooled from 2 RCTs)
I
Intervention
Perioperative beta-adrenergic blockade (metoprolol)
C
Comparator
Placebo
O
Outcome
Cardiac or all-cause mortality, myocardial infarction, and other cardiovascular safety outcomeshard clinical

Perioperative beta-blockade with metoprolol does not reduce cardiac morbidity or mortality in major vascular surgery but significantly increases the risk of intra-operative bradycardia and hypotension.

Limitations

  • One study did not report random sequence generation or allocation concealment techniques
  • One study did not report outcome assessor blinding and was possibly underpowered
  • Several outcomes were only reported in a single study
  • Neither study reported on vascular patency/graft occlusion

Cite This Study

Mostafaie et al. (2015) studied this question.

synapsesocial.com/papers/6a89296a79e515bd750c43a2https://doi.org/10.1002/14651858.cd006342.pub2
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