How strong is the evidence for the use of perioperative beta blockers in non-cardiac surgery? Systematic review and meta-analysis of randomised controlled trials.

Based on prior review articles, the use of perioperative beta blockers in non-cardiac surgery has become a widely recommended patient safety practice. This review, which included a larger sample of more recent literature than prior studies, found that, while beta blockers slightly reduced adverse cardiovascular outcomes (including death), this reduction came at the cost of an increased risk for treatment-requiring hypotension and bradycardia. The authors recommend that enthusiasm for the use of perioperative beta blockers be tempered, and that additional studies be conducted to help inform this important debate.