Safety of perioperative β-blocker use: how do β-blockers compare in terms of side effects?

Abstract

Introduction: 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.

Areas covered: 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.

Expert opinion: 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.

Keywords::

• cardiovascular risk
• myocardial infarction
• perioperative therapy
• β-blockers

Notes

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