Perioperative Beta-blockers inPerioperative Beta-blockers innon-cardiac surgery and thenon-cardiac surgery and thePOISE trial: evidence revisitedPOISE trial: evidence revisited
Moises Auron MD FAAPMoises Auron MD FAAPHospital MedicineHospital MedicineCleveland ClinicCleveland Clinic
OutlineOutline
IntroductionIntroduction
EpidemiologyEpidemiology
Pathophysiology of perioperative ischemia andPathophysiology of perioperative ischemia andrationale for betablockade userationale for betablockade use
Trials supporting use of betablockers.Trials supporting use of betablockers.
Trials suggesting no benefit from addition of Trials suggesting no benefit from addition of betablockersbetablockers
POISE TrialPOISE Trial
ConclusionsConclusions
IntroductionIntroduction
Increased peri-operative Beta-blocker useIncreased peri-operative Beta-blocker usewas based on limited evidence in thewas based on limited evidence in the1990’s suggesting a cardio-protective1990’s suggesting a cardio-protectiveeffect in patients with known or suspectedeffect in patients with known or suspectedCAD.CAD.
Safe practice quality measure: AHRQSafe practice quality measure: AHRQ
Not supported by recent small trialsNot supported by recent small trials
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Perioperative Beta-Blockers in Non-cardiac Surgery and the POISE
The evidence supporting the use of perioperative betablockers is presented.
The controversial POISE trial data showing increased adverse outcomes is presented in detail.
I recommend further lecture of this topic on Dr. Chadi Alraies presentation here on Scribd.
The controversial POISE trial data showing increased adverse outcomes is presented in detail.
I recommend further lecture of this topic on Dr. Chadi Alraies presentation here on Scribd.
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