Department of Surgery, Johns Hopkins Hospital, Baltimore, MD 21287, USA.
J Vasc Surg. 2010 Feb;51(2):515-9. doi: 10.1016/j.jvs.2009.09.057.
Perioperative beta-blocker therapy has been a heavily investigated and controversial topic during the past decade. Prior national consensus statements that recommended the routine use of these medications in patients undergoing high-risk surgical procedures have been called into question because of the results of recent clinical trials that involved heterogeneous groups of surgical patients. This article reviews the evidence for perioperative beta-blocker usage as it pertains to patients undergoing vascular surgery procedures. The weight of evidence suggests that beta-blockers lower the perioperative risk of myocardial ischemia or infarction and cardiovascular death among patients with clinical risk factors undergoing major vascular surgery. However, there appears to be a concurrent risk of adverse events associated with these medications if patients are not monitored properly during the perioperative period. Perioperative beta-blockers should continue to occupy a prominent role in the therapeutic armamentarium for improving outcomes among high-risk patients undergoing major vascular surgery.
在过去的十年中，围手术期β受体阻滞剂治疗一直是一个备受关注和争议的话题。由于最近涉及不同类型手术患者的临床试验结果，先前推荐在高危手术患者中常规使用这些药物的全国共识声明受到了质疑。本文回顾了围手术期使用β受体阻滞剂的证据，这些证据与接受血管外科手术的患者有关。大量证据表明，β受体阻滞剂可降低有临床危险因素的患者接受大血管手术后围手术期心肌缺血或梗死和心血管死亡的风险。然而，如果患者在围手术期未得到适当监测，这些药物似乎存在并发不良事件的风险。围手术期β受体阻滞剂应继续在高危患者接受大血管手术的治疗武器库中占据重要地位，以改善其预后。
