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Discussion

Prophylactic Beta-blockers

I was reading an article about prophylactic perioperative Beta-blockade (PPBB) for high risk cardiac patients. Are any of you guys routinely giving PPBB to those pts?

We have 1 MDA who seems to like to do it but I do not see it done routinely. From what I have read, PPBB can significantly improve intraop MI risk in these high risk CAD pts.

I am interested in others opinions on this. If you are using PPBB, what is your protocol for administration? Is it a regimine started prior to admission or is dosing in the immediate perioperative period sufficient?

From the little I read, it sounds promising, but I would like to learn more. Thanks.

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Trauma - was the article about patients with CAD that weren't already on beta-blockers?

by now, most hospitals have adopted a peri-operative beta-blocker protocol - it is just a matter of being informed about it and following it...

We have adopted a beta blocker protocol at my hospital for surgery patients who meet the criteria. We were seeing quite a bit of arrythmias post op in patients with cardiac histories. I don't know of the actual numbers, but we've heard the BB protocol has been beneficial. As far as who gets the protocol, we have preop forms that print up and if the patient fits the category, they are checked to get the BB protocol. Some patients get preop workup with instructions to take the BB before they admit in to the hospital, others get the BB the first day post op. It all depends on their cardiac risk category.

There is a website http://www.cardiacengineering.com it has everything you need to know about perioperative Beta blocker use for reducing cardiac morbidity. All hospitals should implement protocols, this has been proven to save many lives. This website is awesome it has audio, and was designed by one of the original members of the Atenolol study 1996 NEJM. Check it out.

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