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Resistance to Use of Perioperative  -Blockers: A No-Man’s Land
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Siddiqui et al1 reported underutilization of perioperative  -blockers. We wish to confirm and extend their observation by demonstrating resistance to change.
We prospectively monitored the perioperative use of -blockers, before and after an intervention among the medical staff, as a project of safety and quality at Hadassah University Hospital (a leading academic center in Jerusalem, Israel), following a recent recommendation2 by the Agency of Healthcare Research and Quality.
At baseline, over a period of 6 weeks, 602 patients underwent a noncardiac operation in general surgery, neurosurgery, urology, orthopedics, or gynecology. Of 75 patients who met criteria for -blocker use, none received this treatment (18 had known coronary artery disease [CAD] and 57 had at least 2 CAD risk factors). In 43 patients receiving -blockers before surgery, the treatment was maintained.
An intervention included presentations of current evidence and local use at several departmental meetings of surgery and anesthesiology. An institutional . . . [Full Text of this Article]
AUTHOR INFORMATION
Avishay Grupper, MD;
Mayer Brezis, MD, MPH
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Arch Intern Med. 2004;164(6):664-667.
ABSTRACT
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