Preoperative metoprolol improves cardiovascular stability and reduces oxygen consumption after thoracotomy

Acta Anaesthesiologica Scandinavica
C J JakobsenB Rasmussen

Abstract

Increased sympathetic activity perioperatively and associated cardiovascular effects play a central role in cardiovascular complications. High thoracic epidural blockade attenuates the sympathetic response, but even with complete pain relief, haemodynamic and endocrine responses are still present. Beta-adrenoceptor blockade is effective in situations with increased sympathetic activity. This study was designed to evaluate the perioperative haemodynamic effect of preoperative beta-blockade and its influence on the haemodynamic aspects of the surgical stress response. Thirty-six otherwise healthy patients undergoing elective thoracotomy for lung resection were randomised double-blinded to receive either 100 mg metoprolol or placebo preoperatively. Anaesthesia was combined high thoracic epidural block and general anaesthesia. The epidural analgesia was continued during recovery. Patients were monitored with ECG, pulse oximetry, invasive haemodynamic monitoring, arterial blood gases and electrolytes. After induction of anaesthesia the mean arterial pressure (MAP) decreased in both groups, and decreased further in the placebo group after initiation of the epidural block. The heart rate (HR) was slightly less throughout the observati...Continue Reading

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Citations

May 4, 2005·The Journal of Thoracic and Cardiovascular Surgery·Artyom SedrakyanJan van der Meulen
Apr 10, 2003·The Annals of Thoracic Surgery·Koen De DeckerPaul Van Schil
Mar 10, 2011·Critical Care : the Official Journal of the Critical Care Forum·Steffen ChristensenHenrik Toft Sørensen
Apr 17, 2013·The American Journal of the Medical Sciences·Neng DaiYaWei Xu
Sep 29, 2006·Thoracic Surgery Clinics·John M KaramichalisEric S Lambright
Jan 18, 2006·Anaesthesia·B M BiccardP Foëx
Sep 19, 2006·Anaesthesia·B M BiccardP Foëx
Apr 1, 2009·American Heart Journal·Thomas H MarwickUNKNOWN STRATIFY investigators
Oct 31, 2015·Thoracic Surgery Clinics·Hari B Keshava, Daniel J Boffa
Sep 8, 2009·Journal of Cardiovascular Pharmacology and Therapeutics·Damian Domanski, Ernst R Schwarz
Mar 14, 2018·The Cochrane Database of Systematic Reviews·Hermann BlessbergerClemens Steinwender
Sep 19, 2014·The Cochrane Database of Systematic Reviews·Hermann BlessbergerClemens Steinwender
Sep 27, 2019·The Cochrane Database of Systematic Reviews·Hermann BlessbergerClemens Steinwender
Aug 10, 2000·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·V PiriouJ J Lehot
Sep 6, 2020·British Journal of Anaesthesia·Markus TitzHarald Herkner

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