Perioperative β-blocker use should be tailored for patient and surgical risk factors, most importantly because of the association with increased mortality and stroke when their use is generalised.

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• Xiaoxiao Wang, Claudia Fernandez Robles, and Miklos D Kertai.
• Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut.
• Curr Opin Anaesthesiol. 2020 Jun 1; 33 (3): 417-422.

Purpose Of ReviewAlthough the indications for β-blockers in the management of patients with congestive heart failure and myocardial infarction are well established, the use of β-blockers in the perioperative setting remains controversial.Recent FindingsSince 2008 PeriOperative ISchemic Evaluation Trial, there have been numerous studies suggesting that perioperative β-blockers are associated with adverse events such as hypotension, bradycardia, increased mortality, and stroke.SummaryIn this article, we review the most recent evidence to suggest an approach to perioperative β-blocker use tailored to patient and surgical risk factors. We also review recent studies on off-label uses for perioperative β-blockers.

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