Preoperative propranolol therapy and aortocoronary bypass operation
S. Slogoff, A. S. Keats and E. Ott
The relationship between long-term propranolol hydrochloride therapy and
subsequent coronary bypass operation was prospectively investigated in 119
patients who were grouped three ways: propranolol therapy continued in full
dosage to operation (group A), propranolol therapy discontinued or tapered
24 to 72 hours preoperatively (group B), and no preoperative propranolol
therapy (control group). During preoperative hospitalization, one patient
in each group A and the control group suffered an increase in anginal
symptoms compared with 15 patients in group B, three of whom also had new
ventricular arrhythmias. During anesthesia up to the period of
cardiopulmonary bypass, 26% of group A patients showed signs of ischemia
(eg, ST segment deviation or ventricular arrhythmias) as compared with 51%
of the control group and 70% of group B. Hypotension and bradycardia were
not more common in group A patients. No differences among groups were noted
in case of emergence from bypass, need for cardiac stimulants, or
mortality.
