Perioperative β-blocker use: what is new in 2020?

Purpose of review Although the indications for beta-blockers in the management of patients with congestive heart failure and myocardial infarction are well established, the use of beta-blockers in the perioperative setting remains controversial. Recent findings Since 2008 PeriOperative ISchemic Evaluation Trial, there have been numerous studies suggesting that perioperative beta-blockers are associated with adverse events such as hypotension, bradycardia, increased mortality, and stroke. In this article, we review the most recent evidence to suggest an approach to perioperative beta-blocker use tailored to patient and surgical risk factors. We also review recent studies on off-label uses for perioperative beta-blockers.