Revista Brasileira de Anestesiologia
Print version ISSN 0034-7094
BOSCO, Fabiana Aparecida Penachi and BRAZ, José Reinaldo Cerqueira. Beta-blockers in anesthesiology: clinical and pharmacological aspects. Rev. Bras. Anestesiol. [online]. 2001, vol.51, n.5, pp. 431-447. ISSN 0034-7094. http://dx.doi.org/10.1590/S0034-70942001000500010.
BACKGROUND AND OBJECTIVES: Experimental and clinical data have suggested b-blockers protective hemodynamic effects during anesthesia and surgery. This study aimed at reviewing pharmacological and clinical information needed to prescribe b-blockers in perioperative medicine. CONTENTS: Selective b-blockers inhibit preferentially b1-receptors, decreasing heart rate and inotropism leading to less myocardial oxygen consumption. Non-selective b-blockers also inhibit b2-receptors, increasing bronchial and peripheral vascular resistance. Some b-blockers are also vasodilators. Prolonged treatment with b-blockers increases cell membrane b-receptors density, which may explain sympathetic hyperactivity observed during treatment interruption. In non-cardiac surgeries, beneficial effects of b-blockers have been observed in hypertensive patients and in patients with coronary artery disease, with a decrease in postoperative myocardial ischemia and overall two-year mortality. CONCLUSIONS: Continued administration of b-blockers until anesthesia induction has been encouraged except in patients with signs of intolerance such as hypotension or significant bradycardia. b-blockers have been shown to have beneficial effects on postoperative outcomes in patients with cardiovascular disease or risk factors. Hence, their more widespread use in perioperative medicine is encouraged.
Keywords : DRUGS, Interaction [beta-blockers].