title: Perioperative beta-blockade: might the baby go out with the bath water?
abstract: Perioperative β-blocker therapy has been advocated to reduce cardiac mortality and morbidity in high-risk cardiac patients undergoing non-cardiac surgery. Core data that supported this intervention and informed international societal guidelines has recently been withdrawn. A subsequent meta-analysis of the remaining data reporting excess mortality has re-opened the debate about the utility of β-blocker therapy in the perioperative period. Criticism of remaining trial designs and new insights into the protective mechanisms of β-blocker therapy in critical illness raise important questions that should now be addressed by a further robust, high-quality randomised control trial.
authors.affiliation: Anaesthetics Department, University College Hospital NHS Foundation Trust, London, UK ravin.mistry@nhs.net.
authors.forename: Ravin
authors.initials: R
authors.lastname: Mistry
authors.affiliation: Anaesthetics Department, University College Hospital NHS Foundation Trust, London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Walker
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D003643:Death; D006331:Heart Diseases / Q000188:drug therapy / Q000401:mortality; D006801:Humans; D019990:Perioperative Care / Q000379:methods / Q000401:mortality; D012306:Risk; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*
chemical_list: D000319:Adrenergic beta-Antagonists
keywords: non-cardiac surgery.; perioperative; β-blockers