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β‐Receptor Blockade and Spinal Anaesthesia. Withdrawal versus Continuation of Long‐term Therapy
Author(s) -
Pontén J.,
Biber B.,
Bjurö T.,
Henriksson BÅ.,
Hjalmarson Å.,
Lundberg D.
Publication year - 1982
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1982.tb01890.x
Subject(s) - medicine , blockade , anesthesia , angina , general anaesthesia , lithotomy position , receptor , myocardial infarction , alternative medicine , pathology
A prospective study was performed in 43 men scheduled for transurethral resections under spinal anaesthesia. All patients were on chronic β‐receptor blockade because of hypertension and/or ischaemic heart disease. The patients were randomly subjected to either a gradual preoperative withdrawal or a continuation of the β‐receptor blockade. Haemodynamics were measured non‐invasively. Spinal anaesthesia was performed and an i.v. injection of atropine given. The patients were then placed in a lithotomy position. Mean anaesthetic level included T6. After β‐receptor blocker withdrawal consistently elevated heart rates, a high incidence of arhythmias, angina pectoris and postoperative ST‐T changes indicating myocardial ischaemia were seen. These changes were not seen in patients with continued β‐receptor blockade. Withdrawal of β‐receptor blockers was also associated with an increased total peripheral vascular resistance in connection with spinal anaesthesia. These results suggest that patients on long‐term β‐receptor blockade should continue the therapy during and after spinal anaesthesia.