Background and Aims Intravenous opioids represent the mainstay of pain management for patients undergoing laparoscopic colectomy, even if they are associated with adverse side effects. Intraoperative β-blockers (IBB) may reduce opioid needs in surgical patients.1–4 but no data exist on the effect of the preoperative use of β-blockers (PBB) on opioid consumption. The aim of the study was to determine if PBB users have different opioid requirements and if PONV is less prevalent.
Methods The records of 45 patients undergoing laparoscopic colectomy were reviewed. Variables collected included pre-, intra-, and postoperative opioid use, PONV incidence, and pre-existing β-blocker (BB) prescription. Patients were stratified by BB use and the Wilcoxon Rank-Sum Test was used to assess differences in opioid requirements and PONV incidences.
Results Pre-, intra-, and postoperatively, no statistically significant differences in opioid consumption were found among the two groups (p=0.778, 0.400, and 0.248). PONV incidence was also not significantly different (p=0.726).
Conclusions Although IBB use reduce perioperative opioid consumption and PONV, this effect was not seen in patients already taking BB.One reason why those previously prescribed BB do not show the same results as IBB patients may be due to upregulation and increased sensitivity of β-adrenoreceptors due to chronic BB use.Furthermore, the majority of patients who were prescribed BB had a history of myocardial ischemia which can cause increased catecholamines levels and upregulation of β-adrenoreceptors.While all this may explain the inconsistency between chronic BB and acute IBB use, the role of acute preoperative BB use in opioid-reduction is an unstudied topic that warrants further investigation.
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