Key result
Prophylactic administration of the non-selective beta-blocker pindolol prevented the sympathetic and metabolic responses to the stress of oral surgery, whereas the cardioselective antagonist metoprolol did not.
Why the study?
Does a single oral dose of pindolol compared to metoprolol prevent sympathetic and metabolic responses to stress in patients undergoing oral surgery?
RCT (n=30)
Double-blind
Does a single oral dose of pindolol compared to metoprolol prevent sympathetic and metabolic responses to stress in patients undergoing oral surgery?
Non-selective beta-blockade with pindolol, unlike cardioselective metoprolol, prevents sympathetic and metabolic stress responses during oral surgery.
Answers are grounded in this paper and cite their sources.
Non-selective beta-blockade may blunt perioperative stress responses; leaves open superiority of selectivity in clinical outcomes.
1 The effects of a single oral dose of 5 mg pindolol (P) and 100 mg metoprolol (M) were assessed in a double-blind study in 30 patients undergoing oral surgery. 2 Systolic and diastolic blood pressures and heart rate were reduced 90 min after oral medication and did not exceed initial values at rest during the procedure. 3 Noradrenaline, adrenaline and c-AMP concentrations did not differ at any time from the control values at rest after P, but were increased after local anaesthesia and during oral surgery after M as were the metabolic responses reflected by plasma concentrations of glucose and free-fatty acids. 4 Plasma levels of ACTH and cortisol showed the typical increase during the procedure, being independent of beta-adrenoceptor blockade. In contrast to the cardioselective antagonist M, prophylactic administration of the non-selective drug P prevented the sympathetic and metabolic responses to the stress of oral surgery. 5 Hypothalamic and adrenal stimulation were not reduced by either selective or non-selective beta-adrenoceptor blockade.
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Brisse et al. (1982) conducted an RCT in Stress due to oral surgery (n=30). Pindolol vs. Metoprolol (100 mg) was evaluated on Sympathetic and metabolic responses to surgical stress (including plasma catecholamines, c-AMP, glucose, and free fatty acids). Prophylactic administration of the non-selective beta-blocker pindolol prevented the sympathetic and metabolic responses to the stress of oral surgery, whereas the cardioselective antagonist metoprolol did not.
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