الفهرس | Only 14 pages are availabe for public view |
Abstract Background: Beta-adrenergic receptor blockers have been studied for minimizing the effects of the catecholamine by blocking their activation of beta receptors. They are used to prevent or treat hypertensive crises, tachycardia, ischemic cardiomyopathy and arrhythmias. Several studies have shown the efficacy of such drugs in decreasing postoperative morbidity and mortality. Objectives: To evaluate the effect of perioperative use of beta blocker for coronary artery bypass graft (CABG) patient as regarding ventricular function, incidence of intraoperative and postoperative ischemia and arrhythmia and length of ICU and hospital stay. Patients and Methods: This study was a controlled study conducted at Ain Shams University Hospitals. After obtaining approval of research ethical committee and informed consents from patients during the last two years. 50 patients were divided into 2 groups, study group, who are compliant on oral beta blocker till night of the operation, control group, who are not on proper pre-operative beta blocker control. Results: The study group showed significant lower heart rate intra-operative and post-operative improving the diastolic coronary filling and decreasing the oxygen consumption. Also the study group had a significant improvement in the systolic ventricular functions with lower incidence of intra and post-operative arrythmias with higher incidence of automatic re-beat regaining sinus rhythm as the initial reperfusion rhythm. There was no significant difference in the need for inotropic drugs between the two groups, neither in the number of patients needed nor in the rate of their infusion. Conclusion: For patients undergoing CABG, our study has suggested that peri-operative beta-blocker therapy is beneficial, improving LV functions, decreasing ICU and hospital stay, and decreasing rate of intraoperative and post-operative arrythmias. In the absence of contraindications, nearly all CABG patients are candidates for perioperative beta-blocker therapy. |