The use of preoperative beta (β) blockade has been through several changes, and it is clear that large, randomized controlled trials on the subject are in need. Currently, a judicious approach to perioperative β blockade is supported. Continuation of β blockers is recommended for the patient taking them prior to surgery. Patients undergoing large colorectal procedures, with coronary artery disease or high cardiac risk, should have β blockers titrated to heart rate and blood pressure. Dosages should be titrated to heart rate and blood pressure rather than using fixed, long-acting dosages. When β blockers are indicated, they should be initiated weeks before surgery.
Keywords: colon and rectal surgery; coronary artery disease; perioperative; β blockers.