Is perioperative beta-blockade effective and safe in patients undergoing noncardiac surgery?
Medwave. 2016 Dec 27;16(Suppl5):e6819.
doi: 10.5867/medwave.2016.6819.
[Article in
Spanish,
English]
Affiliations
- 1 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.
- 2 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.
- 3 Proyecto Epistemonikos, Santiago, Chile; Departamento de Anestesiología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
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.
MeSH terms
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Adrenergic beta-Antagonists / administration & dosage*
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Adrenergic beta-Antagonists / adverse effects
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Cardiovascular Diseases / etiology
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Cardiovascular Diseases / prevention & control*
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Humans
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Myocardial Infarction / prevention & control
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Perioperative Care / methods
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Postoperative Complications / prevention & control*
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Randomized Controlled Trials as Topic
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Stroke / epidemiology
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Stroke / etiology
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Surgical Procedures, Operative / methods
Substances
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Adrenergic beta-Antagonists