Safety of perioperative β-blocker use: how do β-blockers compare in terms of side effects?
BACKGROUND
In the perioperative setting, there is still a high incidence of adverse cardiac events due to sudden coronary plaque rupture or oxygen supply-demand imbalance. β-Blockers play an important role in preventing these cardiac events. Discussion, however, remains on the side effects accompanying this therapy.


METHODS
The evidence for perioperative use of β-blockers is summarized in this review in terms of risk reduction, perioperative safety and current clinical use. Furthermore, data on pharmacokinetics, pharmacodynamics and pharmacogenetics are presented.


CONCLUSIONS
In perioperative care, β-blockers are recommended and can be given safely when started early in a low dose, titrated to heart rate. In the future, there could be a place for added perioperative short-acting β-blockers to further optimize heart rate control.
Erasmus Medical Centre, Department of Vascular Surgery, Rotterdam, The Netherlands.
Niels J C
NJ
Ravensbergen
Michiel T
MT
Voute
Don
D
Poldermans
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage* / Q000009:adverse effects* / Q000378:metabolism; D000818:Animals; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D019990:Perioperative Care / Q000379:methods* / Q000592:standards; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D018342:Receptors, Adrenergic, beta-1 / Q000378:metabolism
D000319:Adrenergic beta-Antagonists; D018342:Receptors, Adrenergic, beta-1