β‐Receptor Blockade and Neurolept Anaesthesia. Withdrawal vs Continuation of Long‐Term Therapy in Gall‐Bladder and Carotid Artery Surgery

摘要: Forty-eight chronically (greater than 3 months) beta-receptor-blocked patients with ischaemic heart disease and/or hypertension were studied on 49 occasions after random distribution to a 4-day, gradual preoperative withdrawal (n = 26) or continuation 23) of beta-receptor blockers. The scheduled for either cholecystectomy 28) carotid thrombendarterectomy 21) under neurolept anaesthesia. Three excluded from the randomized part study due complications (tachycardia, hypertension, severe angina) therapy withdrawal. In subgroups, central haemodynamics (beta-receptor blockers withdrawn n 6, continued 8) and creatinine-kinase B 9, 11) studied. Withdrawal was associated high rates, supraventricular tachyarrhythmias hyperkinetic circulation during pain stimuli. Significantly more postoperative ECG changes (P less 0.02) indicative myocardial ischaemia found in blocked patients. These had low rates but also pronounced increases pulmonary capillary wedge pressures, which single could be damage. results imply that should before surgery concomitant vasodilatatory is likely avoid drawbacks an increased cardiac afterload.