Beta-adrenergic agonists and antagonists.

Beta adrenergic antagonists are a complex group of agents. The profusion of newer agents will allow us to discover nuances of difference between them, but that will be a future development. Currently, our concerns should be obtaining extensive experience with propranolol, controlling intraoperative and postoperative tachycardia; using beta blockade as adjunctive therapy during vasodilator administration; using beta blockade as part of "balanced" anesthesia, especially in patients with coronary artery disease; and learning sophisticated ways of preoperatively and intraoperatively evaluating hemodynamics so as to be able to decide when and how to best utilize the drugs. Beta agonists recently introduced include dopamine and dobutamine. Differences and similarities are numerous. Overriding in adults, at least, may be the ability of dopamine to stimulate renal dopaminergic receptors to increase renal blood flow.