title: Is perioperative beta-blockade effective and safe in patients undergoing noncardiac surgery?
abstract: Beta-blockade in patients undergoing noncardiac surgery has been widely recommended as a way to reduce cardiovascular adverse events during the perioperative period. However, studies have shown contradictory results. Searching in Epistemonikos database, which is maintained by screening multiple databases, we identified 22 systematic reviews comprising 131 studies addressing the question of this article, including 112 randomized trials. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded perioperative use of beta-blockers in patients undergoing noncardiac surgery, although probably decreases the risk of myocardial infarction, increases the risk of stroke and total mortality.
authors.affiliation: Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile. Email: fernando.altermatt@gmail.com. Address: Facultad de Medicina, Pontificia Universidad Católica de Chile, Lira 63, Santiago Centro, Chile.
authors.forename: Andrés
authors.initials: A
authors.lastname: Armstrong
authors.affiliation: Proyecto Epistemonikos, Santiago, Chile; Programa de Salud Basada en Evidencia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Departamento de Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; GRADE working group; The Cochrane Collaboration.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Rada
authors.affiliation: Proyecto Epistemonikos, Santiago, Chile; Departamento de Anestesiología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Fernando
authors.initials: F
authors.lastname: Altermatt
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D009203:Myocardial Infarction / Q000517:prevention & control; D019990:Perioperative Care / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000453:epidemiology / Q000209:etiology; D013514:Surgical Procedures, Operative / Q000379:methods
chemical_list: D000319:Adrenergic beta-Antagonists