Perioperative β-blockers for vascular surgery patients

Perioperative β-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 β-blocker usage as it pertains to patients undergoing vascular surgery procedures. The weight of evidence suggests that β-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 β-blockers should continue to occupy a prominent role in the therapeutic armamentarium for improving outcomes among high-risk patients undergoing major vascular surgery.