Boudoulas H, Lewis R P, Snyder G L, Karayannacos P, Vasko J S
Clin Cardiol. 1979 Apr;2(2):87-91. doi: 10.1002/clc.4960020202.
The safety and beneficial effect of continuation of propranolol (Pr) through coronary bypass surgery (CBS) was studied in two groups of patients. In the control group (50 patients) Pr was discontinued 24 h before CBS without reinstitution afterwards. In the propranolol group the drug was maintained up to 4 to 10 h before surgery and was restarted within 24 h afterwards. The incidence of subendocardial myocardial infarction was significantly lower in the Pr group (1 out of 30 vs 10 out of 50, p less than 0.05) while the incidence of transmural infarction was the same in both groups (3 out of 30, 10%, vs 5 out of 50, 10%). The incidence of supraventricular tachycardias during the first three postoperative days was significantly lower in the propranolol group compared to control (5% vs 30%, p less than 0.01). The 24 h urinary epinephrine and norepinephrine excretion was significantly greater than normal the day before surgery (136 +/- 12 vs 39 +/- 4 micrograms/24 h, p less than 0.01), and was still high two weeks after surgery (115.1 +/- 14 micrograms/24 h). There were no complications related to propranolol. The left ventricular function as measured from the systolic time intervals was the same pre- and postoperatively in both groups. The results of this study show that administration of propranolol up to 4 h before coronary bypass and reinstitution immediately afterwards is safe and beneficial.
在两组患者中研究了冠状动脉搭桥手术（CBS）期间继续使用普萘洛尔（Pr）的安全性和有益效果。在对照组（50例患者）中，Pr在CBS前24小时停用，之后不再重新用药。在普萘洛尔组中，该药物在手术前维持使用4至10小时，并在术后24小时内重新开始使用。Pr组心内膜下心肌梗死的发生率显著低于对照组（30例中的1例 vs 50例中的10例，p<0.05），而透壁性梗死的发生率在两组中相同（30例中的3例，10%，vs 50例中的5例，10%）。与对照组相比，普萘洛尔组术后前三天室上性心动过速的发生率显著降低（5% vs 30%，p<0.01）。手术前一天24小时尿肾上腺素和去甲肾上腺素排泄量显著高于正常水平（136±12 vs 39±4微克/24小时，p<0.01），术后两周仍较高（115.1±14微克/24小时）。未出现与普萘洛尔相关的并发症。两组术前和术后通过收缩期时间间期测量的左心室功能相同。本研究结果表明，在冠状动脉搭桥术前4小时使用普萘洛尔并在术后立即重新用药是安全且有益的。
