Continuous propranolol infusion following abdominal surgery

• Published in: JAMA : the journal of the American Medical Association Vol. 247; no. 18; p. 2539
• Main Authors: Smulyan, H, Weinberg, S E, Howanitz, P J
• Format: Journal Article
• Language: English
• Published: United States 14.05.1982
• Subjects: Abdomen - surgery; Adult; Aged; Female; Heart Diseases - complications; Heart Diseases - drug therapy; Humans; Infusions, Parenteral; Male; Middle Aged; Postoperative Care; Propranolol - administration & dosage; Propranolol - blood
• ISSN: 0098-7484; 1538-3598
• DOI: 10.1001/jama.1982.03320430043029

Thirteen patients given long-term propranolol hydrochloride therapy for heart disease required 15 abdominal surgical procedures. On each occasion, propranolol therapy was maintained postoperatively by continuous intravenous infusion. Duration of infusion ranged from one to nine days, and each infusion was monitored with frequent measurements of serum propranolol concentrations. In patients with normal hepatic and renal function, therapeutic serum propranolol levels were attained with a narrow dose range averaging 3.0 mg/hr, irrespective of body weight. All patients had postoperative courses free of complications attributable to beta-blockade. This form of therapy appears to protect against sympathetic stimulation during the perioperative period and to prevent the propranolol withdrawal syndrome in such patients. Continuous propranolol infusion might also be useful in other clinical situations, such as acute aortic dissection or severe thyrotoxicosis, where predictable therapeutic serum propranolol levels could be maintained when oral therapy was contraindicated.