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Invited Critique
May 2012

To Block or Not to Block?Comment on “β-Blocker Continuation After Noncardiac Surgery”

Author Affiliations

Author Affiliation: Department of Surgery, Huntsman Cancer Hospital, University of Utah, Salt Lake City.

Arch Surg. 2012;147(5):473. doi:10.1001/archsurg.2011.2235

The controversy around perioperative β-blockade (initiation or continuation) has raged for more than 20 years. In 1996, Mangano and colleagues1 reported the results of a randomized clinical trial that showed perioperative β-blockade reduced cardiac mortality for up to 2 years following surgery. This led to an increased rate of β-blocker initiation preoperatively as well as Surgical Care Improvement Project process measures to document adherence to a seemingly life-saving intervention.

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