Beta-blockers in the Perioperative Period: Are there Indications other than Prevention of Cardiac Ischemia?

Beta-blocker therapy is accepted to reduce perioperative cardiovascular complications. Moreover, betablockers have potentially beneficial effects other than prevention of cardiac events. In addition to reducing anesthetic and analgesic requirements during the perioperative period, beta-blockers have neuroprotective effects, possible effectiveness in the management of intraoperative awareness-induced post-traumatic stress disorder, and antinociceptive effects. Betablockers are also useful in stabilizing hemodynamics during electroconvulsive therapy, intubation and emergency periods. Physicians need to bear in mind the benefits of beta-blockers for purposes other than preventing cardiac events when applied in the perioperative period, and should be familiar with the pharmacodynamics and effective dosages of these agents.