Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

VA Health Systems Research

Go to the VA ORD website
Go to the QUERI website

HSR Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

Effectiveness of preoperative beta-blockade on intra-operative heart rate in vascular surgery cases conducted under regional or local anesthesia.

Mudumbai SC, Wagner T, Mahajan S, King R, Heidenreich PA, Hlatky M, Wallace AW, Mariano ER. Effectiveness of preoperative beta-blockade on intra-operative heart rate in vascular surgery cases conducted under regional or local anesthesia. SpringerPlus. 2014 May 5; 3:227.

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information vaww.hsrd.research.va.gov/dimensions/

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.
   Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions



Abstract:

BACKGROUND: Preoperative ß-blockade has been posited to result in better outcomes for vascular surgery patients by attenuating acute hemodynamic changes associated with stress. However, the incremental effectiveness, if any, of ß-blocker usage in blunting heart rate responsiveness for vascular surgery patients who avoid general anesthesia remains unknown. METHODS: We reviewed an existing database and identified 213 consecutive vascular surgery cases from 2005-2011 conducted without general anesthesia (i.e., under monitored anesthesia care or regional anesthesia) at a tertiary care Veterans Administration medical center and categorized patients based on presence or absence of preoperative ß-blocker prescription. For this series of patients, with the primary outcome of maximum heart rate during the interval between operating room entry to surgical incision, we examined the association of maximal heart rate and preoperative ß-blocker usage by performing crude and multivariate linear regression, adjusting for relevant patient factors. RESULTS: Of 213 eligible cases, 137 were prescribed preoperative ß-blockers, and 76 were not. The two groups were comparable across baseline patient factors and intraoperative medication doses. The ß-blocker group experienced lower maximal heart rates during the period of evaluation compared to the non-ß-blocker group (85?±?22 bpm vs. 98?±?36 bpm, respectively; p? = 0.002). Adjusted linear regression confirmed a statistically-significant association between lower maximal heart rate and the use of ß-blockers (Beta? = -11.5; 95% CI [-3.7, -19.3] p? = 0.004). CONCLUSIONS: The addition of preoperative ß-blockers, even when general anesthesia is avoided, may be beneficial in further attenuating stress-induced hemodynamic changes for vascular surgery patients.





Questions about the HSR website? Email the Web Team

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.