Perioperative use of beta-blockers in vascular and endovascular surgery

Editor—We were disappointed to read the content of the recent article by Hajibandeh and colleagues¹ in the British Journal of Anaesthesia. Since the early, implausible reports of long-term benefit attributable to short-term perioperative beta-blockade, there has been increasing scepticism of this treatment among both anaesthetists and cardiologists.^2–8 Following the early criticisms of publications by Mangano and colleagues and Poldermans' group, the specialty of anaesthesia has discovered that the conclusions of these workers were baseless.⁹ This is because of a flawed analysis on the basis of 'intention to treat' with respect to the study by Mangano and colleagues and a seriously discredited first author in the case of the Poldermans' study.²⁸³

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