Perioperative Beta-Blocker Management

CA-2 · II.C.1.c.2.a.4 II.D.3.i.6 II.D.2.g.6.b

24Sources
6Kept
0Dropped

1 · Find evidence

PubMed query

Every result is a real PMID returned by NCBI. Nothing on this step is generated.

Ask OpenEvidence ↗

OpenEvidence opens in your own logged-in session with the question filled in. Nothing is fetched on your behalf — read it there, then add what you want to teach as a point below, citing the source it came from.

24 candidate papers

Ticked papers are the ones a deck may be built from. Unticking one needs a reason — the citation gate proves a paper exists, and nothing but you decides whether it should be taught. A tier badge appears where the paper’s publication type is known.

Same-day build

PubMed query

Runs the tiered searches, drafts one point per included paper, runs the citation gate and builds a draft deck — the steps below, unattended. Same-day build — drafted locally (medgemma:27b), confirmed against each abstract. The deck still lands in draft: nothing here approves anything.

2 · Teaching points

Source

A point with no source will not survive the gate. That is the point of the gate.

6 points

Pooling only the trials whose data remain secure, starting a beta-blocker before noncardiac surgery increased 30-day all-cause mortality by 27%, and increased stroke and hypotension while reducing non-fatal myocardial infarction. PMID 23904357 kept
Starting extended-release metoprolol before noncardiac surgery reduced myocardial infarction from 5.7% to 4.2% but increased death from 2.3% to 3.1% and doubled stroke from 0.5% to 1.0%. PMID 18479744 kept
The association between perioperative beta-blockade and survival tracks baseline risk: benefit appeared at a Revised Cardiac Risk Index of 2 or more, with no benefit and possible harm at a score of 0 or 1. PMID 16049209 kept
Ultra-short-acting agents such as esmolol and landiolol offer the effects of beta-blockade without the detrimental effects of long-acting agents, which are hard to counteract once given perioperatively. PMID 29398384 kept
Beta-blocker exposure around major noncardiac surgery was associated with lower 30-day mortality only in patients with two or more Revised Cardiac Risk Index factors, and only in nonvascular surgery. PMID 23613075 kept
Long-term preoperative beta-blocker prescription is independently associated with increased postoperative ischaemic stroke risk at 30 and 365 days, especially in lower-risk patients. PMID 42290631 kept

Checks every citation against PubMed, the DOI resolver, or a live fetch. Points that do not resolve are dropped and shown to you with the reason — never quietly softened.

4 · Build the deck

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5 · Question bank

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