On the surgical clinical services, we have in the past routinely and religiously used beta blockers on the assumption that they promote improved clinical outcomes. There is growing evidence that they do not improve clinical outcomes in non cardiac surgery in patients not previously on them. This has obviously come as a shock to many surgery residents who were often berated as juniors for not having prescribed metoprolol to a patient postoperatively.

Read the meta analyses below and have an opinion. You need to have one. And if you feel strongly enough about it - go ahead and post it on the blog.

Bangalore S, Wetterslev J, Pranesh S, et al. Perioperative beta blockade in patients having non-cardiac surgery: a meta-analysis. Lancet 2008; DOI: 10.1016/S0140-6736(08)61560-3. Available at: http://www.thelancet.com.
Boersma and Poldermans. Beta blockers in non-cardiac surgery: haemodynamic data needed. Lancet 2008; DOI: 10.1016/S0140-6736(08)61623-2. Available at: http://www.thelancet.com.

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