The use of beta-blockers to decrease adverse perioperative cardiac events.

As the population ages, more surgeries are performed on patients with increased risk factors. Many of these surgeries will result in complications and mortality. Myocardial ischemia is often associated with cardiac complications in the perioperative patient. Unfortunately, an episode of myocardial ischemia will result in a 70% mortality rate. Perioperative patients are complex because of their atypical presentation, incisional pain, and the effects of analgesia. The critical care nurse must be able to determine a patient's risk factors and surgical risks and then take measures to ensure that the patient receives adequate treatment both before and after surgery. beta-Blockers may decrease a patient's risk of developing myocardial ischemia, yet they are often underused. A multidisciplinary approach is needed to ensure the proper use of beta-blockers in an effort to reduce cardiac complications in the perioperative elderly patient.