Effect of metoprolol and diazepam on pre‐operative anxiety

Abstract

Summary

Perioperative β blockers in patients having non-cardiac surgery: a meta-analysis

“…High-bias risk trials POBBLE 3 Poldermans 32 Jakobsen 46 Jakobsen 34 Lai 35 Magnusson 37 Magnusson 50 Stone 38 Urban 39 Zaugg 3 Poldermans 32 Jakobsen 46 Lai 35 Magnusson 37 Magnusson 50 Miller 40 Stone 38 Urban 39 Zaugg High-bias risk trials Jakobsen 426 Lai 35 Liu 36 Magnusson 50 POBBLE 3 Poldermans 32 Urban 39 Zaugg 33 Jakobsen 46 Stone …”

“…High-bias-risk trials Burn 41 Coleman 42 Jakobsen 46 Jakobsen 45 Liu 48 Liu 36 Mackenzie 49 Magnusson 37 Stone on the outcomes of cardiovascular mortality and heart failure (figures 2 and 3). A test for interaction showed significant effects of trial quality on all-cause mortality, cardiovascular mortality, and non-fatal myocardial infarction (figures 2 and 3).…”

“…However, there was a greater risk of perioperative hypotension (figure 5) requiring treatment in high-bias risk trials than in low-bias risk trials with a significant test for interaction (p=0·041). High-bias-risk trials Inada 44 Jakobsen 46 Jakobsen 45 Jakobsen 24 Leslie 47 Mackenzie See Online for webfigure 4…”

“…Five trials enrolled high surgical-risk patients (emergency surgery, vascular surgery), 3,5,27,32,40 five enrolled intermediate-risk or high surgical-risk patients, 4,6,28,30,38 22 enrolled intermediate surgical-risk patients (intrathoracic, intraperitoneal, carotid endarterectomy, head and neck, orthopedic, or prostate surgery), [22][23][24][25][26]31,[33][34][35][36][37]39,[41][42][43][44][45][46][47][48][49][50] and one enrolled low surgical-risk patients. 29 A sensitivity analysis on the basis of surgical risk categories showed a 63% decreased risk of all-cause mortality and a 44% decreased risk of non-fatal myocardial infarction in trials with high surgical risk (tables 2 and 3); this finding was driven largely by the trial by Poldermans and colleagues.…”

“…15 trials achieved a mean heart rate of 75 beats per min or less at study end in the β-blocker group, [3][4][5][6]25,28,31,32,34,36,37,43,45,46,50 whereas in nine trials the mean heart rate was greater than 75 beats per min. 23,26,29,30,33,35,38,39,48 Heart rate achieved was not significant for any of the efficacy outcomes apart from non-fatal myocardial infarction-trials that achieved heart rate of 75 beats per min or less reported a lower reduction in risk than did the other group (tables 2 and 3).…”