Author:
Weiner Bruce,Lopes Carlos A.,Amato Joseph J.,Cleveland Richard J.
Abstract
Withdrawal of propranolol before cardiac surgery has been a controversial issue. Six case reports of patients undergoing aorto-coronary bypass surgery with varying schedules of propranolol withdrawal are described. The mechanisms of the propranolol withdrawal rebound phenomenon are reviewed. It is recommended that propranolol not be withdrawn completely before surgery. Continuing propranolol up to the time of surgery may have a protective effect in patients with severe coronary artery disease. The risk of death from the rebound phenomenon may be greater than the risk from the perioperative cardiac depressant effects of propranolol.
Subject
Pharmacology (medical),General Pharmacology, Toxicology and Pharmaceutics