• Niels J C Ravensbergen, Michiel T Voute, and Don Poldermans.
• Erasmus Medical Centre, Department of Vascular Surgery, Rotterdam, The Netherlands.
• Expert Opin Drug Saf. 2011 Jul 1; 10 (4): 545-58.

IntroductionIn the perioperative setting, there is still a high incidence of adverse cardiac events due to sudden coronary plaque rupture or oxygen supply-demand imbalance. β-Blockers play an important role in preventing these cardiac events. Discussion, however, remains on the side effects accompanying this therapy.Areas CoveredThe evidence for perioperative use of β-blockers is summarized in this review in terms of risk reduction, perioperative safety and current clinical use. Furthermore, data on pharmacokinetics, pharmacodynamics and pharmacogenetics are presented.Expert OpinionIn perioperative care, β-blockers are recommended and can be given safely when started early in a low dose, titrated to heart rate. In the future, there could be a place for added perioperative short-acting β-blockers to further optimize heart rate control.

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