Salazar C, Frishman W, Friedman S, Patel J, Lin Y T, Oka Y, Frater R W, Becker R M
Angiology. 1979 Dec;30(12):816-9. doi: 10.1177/000331977903001204.
A high incidence of cardiac arrhythmias and hypertension has been noted after coronary artery bypass surgery in patients previously treated with oral propranolol. Forty-two patients undergoing coronary bypass surgery had propranolol withdrawal 10 hours before surgery and were randomized into a group treated with propranolol immediately postoperatively, and a nontreatment group. Patients treated with prophylactic propranolol had a significantly lower incidence of postoperative supraventricular arrhythmias compared to patints who received no prophylaxis. All the arrhythmias responded rapidly to 1 mg of intravenous propranolol therapy, whether it was used as a primary treatment or as a supplement to prophylactic propranolol. The findings suggest that (1) there is a high incidence of supraventricular arrhythmias and sinus tachycardia after coronary artery bypass which might reflect an abrupt propranolol withdrawal, and (2) that perioperative prophylactic or supplementary propranolol therapy will successfully prevent or treat most of these arrhythmias.
在先前接受口服普萘洛尔治疗的患者中，冠状动脉搭桥手术后已观察到心律失常和高血压的高发病率。42例接受冠状动脉搭桥手术的患者在手术前10小时停用普萘洛尔，并被随机分为术后立即接受普萘洛尔治疗的组和未治疗组。与未接受预防治疗的患者相比，接受预防性普萘洛尔治疗的患者术后室上性心律失常的发生率显著更低。所有心律失常对1毫克静脉注射普萘洛尔治疗均迅速起效，无论其用作初始治疗还是预防性普萘洛尔的补充治疗。研究结果表明：（1）冠状动脉搭桥术后室上性心律失常和窦性心动过速的发生率较高，这可能反映了普萘洛尔的突然停用；（2）围手术期预防性或补充性普萘洛尔治疗将成功预防或治疗大多数此类心律失常。
