Beta blockers in perioperative management: what is the recommendation?

Beta blockers in perioperative management: what is the recommendation?

• A. Continue perioperatively.
• B. Hold perioperatively.
• C. Never use in perioperative care.
• D. Only use postoperatively.

Answer: (A)

Continuing beta-blocker therapy through the perioperative period is best because abrupt withdrawal can trigger a surge in sympathetic activity, leading to higher heart rate, blood pressure spikes, and an increased risk of myocardial ischemia or infarction during surgical stress. Maintaining the regular beta-blockade provides steadier hemodynamics and helps blunt tachycardia and hypertension that anesthesia and pain can provoke, reducing perioperative cardiac events in patients already on these medications. Initiating beta-blockade for the first time around surgery hasn’t consistently shown clear benefit and can cause adverse effects such as hypotension, bradycardia, or heart block, so the aim is to keep patients on their established regimen rather than start new therapy just before or during surgery. Holding or never using beta-blockers omits these protective effects and the withdrawal risk, and using them only postoperatively fails to address perioperative stress.

Continuing beta-blocker therapy through the perioperative period is best because abrupt withdrawal can trigger a surge in sympathetic activity, leading to higher heart rate, blood pressure spikes, and an increased risk of myocardial ischemia or infarction during surgical stress. Maintaining the regular beta-blockade provides steadier hemodynamics and helps blunt tachycardia and hypertension that anesthesia and pain can provoke, reducing perioperative cardiac events in patients already on these medications. Initiating beta-blockade for the first time around surgery hasn’t consistently shown clear benefit and can cause adverse effects such as hypotension, bradycardia, or heart block, so the aim is to keep patients on their established regimen rather than start new therapy just before or during surgery. Holding or never using beta-blockers omits these protective effects and the withdrawal risk, and using them only postoperatively fails to address perioperative stress.