Journal article
Assessment of Prospectively Randomized Patients Receiving Propranolol Therapy before Coronary Bypass Operation
The Annals of thoracic surgery, v 30(2)
Aug 1980
PMID: 6968186
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Abstract
Fifty patients receiving propranolol were randomized into two groups of 25 patients each. One group received the last dose of propranolol within 4 hours of operation and were on a regimen of 160 mg daily. The second group had propranolol discontinued 24 to 48 hours prior to operation. Two nonrandomized control groups consisted of 25 patients who had never had propranolol and 15 patients who were on a regimen of 160 mg or more and who were operated on for unstable angina. Blood levels of propranolol were obtained just prior to incision.
Several hemodynamic variables were assessed prior to anesthetic induction, at peak response during the early anesthetic period, and at the termination of cardiopulmonary bypass. Strict criteria were enforced for the administration of inotropic agents and the incidence of myocardial injury in the various groups was tabulated. Significant differences were present in the form of lower pressure-rate products in the patients maintained on propranolol therapy. The incidence of inotropic support, however, was also higher within the subgroups of patients who had propranolol immediately prior to operation. When examined further, increased inotropic requirements existed in patients having 320 to 480 mg of propranolol just before operation; this finding correlated with serum propranolol levels measured at the time of operation. This tightly controlled study supports the maintenance of propranolol for its beneficial perioperative hemodynamic effects but suggests that maintenance of doses of 320 to 480 mg per day are associated with a greater duration and extent of action that may transiently affect early postoperative hemodynamic performance.
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Details
- Title
- Assessment of Prospectively Randomized Patients Receiving Propranolol Therapy before Coronary Bypass Operation
- Creators
- Andrew S. Wechsler - Duke Medical Center
- Publication Details
- The Annals of thoracic surgery, v 30(2)
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine; [Retired Faculty]
- Web of Science ID
- WOS:A1980KD42900007
- Scopus ID
- 2-s2.0-0018973415
- Other Identifier
- 991020705351304721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Respiratory System
- Surgery