Beta Blockade Periop

Beta Blockade Periop
-----------------

Atenolol 5-10 mg IV 30 min before and after surgery.
50-100 mg/d by mouth throughout the hospital stay for a max of 7 days.

Target HR 55-65/min - dose held for HR < 55 or SBG < 100 mm Hg.

Candidates - minor criteria: meeting any two of the following:
1. Age 65 or older
2. HTN
3. Current smoker
4. Serum choles at least 240 mg/dl
5. DM not requiring insulin.

Revised cardiac risk index criteria: use beta blockers in patients meeting
ANY of the following criteria -
1. High risk surg proced: intraperitoneal, intrathoracic, suprainguinal
vascular procedures.
2. Ischemic heart disease - hx of MI, hx of or current angina; sublingual
NTG; pos exercise test results; Q waves on EKG; PTCA or CABG and have chest
pain
3. Cerebrovasc disease - hx of TIA, CVA.
4. DM requiring insulin
5. Chronic renal insufficiency baseline Cr of at least 2.0 mg/dl