Gaining control: can we reduce perioperative cardiovascular complications?
Cardiovascular complications are common in patients at risk for coronary disease undergoing surgery. The role of hyperactivity of the sympathetic nervous system and impaired parasympathetic control mechanisms in the genesis and consequences of perioperative myocardial ischemia has been discussed. Sympathetic blocking drugs of the beta blocker and alpha2agonist classes have been used extensively in the perioperative setting to control hemodynamic responses and reduce episodes of myocardial ischemia. To date, perioperative beta blockade is the only strategy shown to improve long-term outcome after surgery in this population.
Department of Anesthesiology, Queen's University, Kingston General Hospital, Kingston, Ontario, Canada. parlowj@post.queensu.ca.
Joel
J
Parlow