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Influence of a chronic beta-blocker therapy on perioperative opioid consumption : a post hoc secondary analysis

  • Background Beta-blocker (BB) therapy plays a central role in the treatment of cardiovascular diseases. An increasing number of patients with cardiovascular diseases undergoe noncardiac surgery, where opioids are an integral part of the anesthesiological management. There is evidence to suggest that short-term intravenous BB therapy may influence perioperative opioid requirements due to an assumed cross-talk between G-protein coupled beta-adrenergic and opioid receptors. Whether chronic BB therapy could also have an influence on perioperative opioid requirements is unclear. Methods A post hoc analysis of prospectively collected data from a multicenter observational (BioCog) study was performed. Inclusion criteria consisted of elderly patients (≥ 65 years) undergoing elective noncardiac surgery as well as total intravenous general anesthesia without the use of regional anesthesia and duration of anesthesia ≥ 60 min. Two groups were defined: patients with and without BB in their regular preopreative medication. The administered opioids were converted to their respective morphine equivalent doses. Multiple regression analysis was performed using the morphine-index to identify independent predictors. Results A total of 747 patients were included in the BioCog study in the study center Berlin. 106 patients fulfilled the inclusion criteria. Of these, 37 were on chronic BB. The latter were preoperatively significantly more likely to have arterial hypertension (94.6%), chronic renal failure (27%) and hyperlipoproteinemia (51.4%) compared to patients without BB. Both groups did not differ in terms of cumulative perioperative morphine equivalent dose (230.9 (BB group) vs. 214.8 mg (Non-BB group)). Predictive factors for increased morphine-index were older age, male sex, longer duration of anesthesia and surgery of the trunk. In a model with logarithmised morphine index, only gender (female) and duration of anesthesia remained predictive factors. Conclusions Chronic BB therapy was not associated with a reduced perioperative opioid consumption.

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Author:Ralf Felix TrauzeddelORCiD, Luisa M. Rothe, Michael NordineORCiD, Lukas DehéORCiD, Kathrin ScholtzORCiD, Claudia SpiesORCiD, Daniel HadzidiakosORCiD, Georg WintererORCiD, Friedrich BorchersORCiD, Jochen Kruppa-ScheetzORCiD, Sascha TreskatschORCiD
Title (English):Influence of a chronic beta-blocker therapy on perioperative opioid consumption : a post hoc secondary analysis
Parent Title (English):BMC Anesthesiology
Document Type:Article
Year of Completion:2024
Release Date:2024/04/10
Tag:Beta-blocker therapy; Cardiovascular; Noncardiac surgery; Opioids
Article Number:80
Page Number:10
Faculties:Fakultät AuL
DDC classes:600 Technik, Medizin, angewandte Wissenschaften / 610 Medizin, Gesundheit
Review Status:Veröffentlichte Fassung/Verlagsversion
Licence (German):License LogoCreative Commons - CC BY - Namensnennung 4.0 International