Further reflections on recent updates to perioperative beta-blocker guidelines.

摘要

"For every complex problem, there is an answer that is clear, simple, and wrong." H.L. Mencken. In a recent editorial on perioperative beta-blockers, London noted that, "The current process (on guidelines for perioperative beta-blockers) appears to be limited increasingly to the...few effective Class I practices..., leaving the majority of real world clinical controversy in the nebulous Class II category." I write to provide several additional perspectives to this discussion. The foremost viewpoint, given the potential problems of guidelines, is that the issue is not about the guidelines per se, but about the often overlooked postoperative care on surgical wards.