The case for beta-adrenergic blockade as prophylaxis against perioperativecardiovascular morbidity and mortality

Perioperative morbidity and mortality are frequently cardiac in origin, Man y studies have prospectively attempted to define risk factors for cardiac i schemic events. Although we can now identify high-risk patients, optimal ca rdioprotective management strategies remain unclear. Treatment with P-adren ergic antagonists decreases myocardial oxygen consumption and is generally well tolerated. This article reviews the physiologic and clinical basis for using these agents as prophylaxis against cardiovascular events in high-ri sk surgical patients.