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Why You Shouldn’t Start β-Blockers Before Surgery

A new meta-analysis finds that initiating β-blockers before surgery increases patients’ risk for death.

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PRACTICE CHANGER

Do not routinely initiate β-blockers in patients undergoing intermediate- or high-risk noncardiac surgery. β-Blockers appear to increase the 30-day risk for all-cause mortality.1

STRENGTH OF RECOMMENDATION

A: Based on meta-analysis of nine randomized controlled trials (RCTs).1

ILLUSTRATIVE CASE
A 67-year-old woman with diabetes, hypertension, and hyperlipidemia presents for evaluation prior to a total hip arthroplasty. She is not taking a β-blocker. Should you prescribe one?

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