Somewhere on here somebody presently a nice simple breakdown of the preoperative cardiac testing and beta blockade guidelines. Could anyone of you kind gentleman please repeat that. Thank you.
For this one time, and one time only, I'll accept help from Obama supporters on this one.
Someone correct me if I'm wrong, but I don't think there is a "guideline" for perioperative beta-blockade. The POISE trial highlighted the fact that patients (especially ASA I and ASA II) that are treated with perioperative beta-blockers have a higher inccidence of stroke. It really left more questions than answers. Duration of beta-blockade is also not exact.
What is for sure: If you are on them, then continue them.
If you are healthy: Don't take them.
If you may be a candidate (ASA III/IV) and are not on them, a risk/benefit assesment needs to be made.
http://bja.oxfordjournals.org/content/101/2/135.full
Not sure if this is the most up to date information on beta-blockade.
Perioperative Cardiac Evaluation centers around a couple of issues:
1. Surgical risk
2. Major/Minor Risk Factors
3. Functional Capacity
4. Emergent Nature of the Surgery
5. Most importantly, will the results of cardiac workup change your treatment plan?
Another way to look at perioperative assesment is:
A. What is the nature of the disease?
B. Are they optimized?
