Limited Effect of Beta-blockade on Postoperative Outcome After Laparoscopic Gastric Bypass Surgery

Abstract

Background The benefit of beta-blockade on postoperative outcome remains controversial, though recent studies have suggested a role during major non-cardiac surgery. The benefit of beta-blockade during minimally invasive gastric bypass surgery remains unclear. The aim of the present study was to evaluate the possible association between preoperative beta-blocker therapy and postoperative outcome after laparoscopic gastric bypass surgery. Methods Patients operated with primary laparoscopic gastric bypass surgery in Sweden between 2007 and 2017 were identified through the Scandinavian Obesity Surgery Registry. The dataset was linked to the Swedish National Patient Registry, the Swedish Prescribed Drug Registry, and Statistics Sweden. The main outcome was serious postoperative complication within 30 days of surgery; with postoperative complication, 90-day and 1-year mortality, and weight loss at 2 years after surgery as secondary endpoints. The Poisson regression model was used to evaluate primary and secondary categorical outcomes. A general mixed model was performed to evaluate 2-year weight loss. Results In all, 50281 patients were included in the study. No difference was seen between patients on beta-blockade and the control group regarding postoperative complications (adjusted incidence rate ratio 1.04 (95%CI 0.93-1.15), p = 0.506), serious postoperative complication (adjusted IRR 1.06 95%CI 0.89-1.27), p = 0.515), 90-day mortality (adjusted IRR 0.71 (95%CI 0.24-2.10), p = 0.537), and 1-year mortality (adjusted IRR 1.26 (95%CI 0.67-2.36), p = 0.467). Weight loss 2 years after surgery was slightly greater in patients on beta-blockade (adjusted coefficient 0.53 (95%CI 0.19-0.87), p = 0.002). Conclusions Beta-blockade has limited impact on postoperative outcome after laparoscopic gastric bypass surgery.

Continuous remote monitoring in post–bariatric surgery patients: development of an early warning protocol

“…Sepsis and infection as the sole cause of death after noncardiac surgery were seen more commonly in patients using beta-blockers in one study [29]. On the other hand, limited effects of these blockers have been shown on postoperative outcomes after laparoscopic gastric bypass [30] which is in accordance with the findings in the current study. However, limited by the number of events and the low amount of beta-blocker use, this finding cannot yet be extrapolated to clinical application.…”

Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: A 2021 Update

“…Only one retrospective study assessed the association between preoperative beta-blocker therapy and postoperative outcome for patients undergoing laparoscopic RYGB. There was no evidence for a beneficial effect on moderate- and long-term survival and postoperative complications [ 72 ]. At present, it is not recommended to routinely use perioperative beta-blockers in patients undergoing bariatric surgery.…”

Pre-operative beta-blocker therapy does not affect short-term mortality after esophageal resection for cancer

“…There is growing heterogeneity in publications outlining the impact of preoperative β-blocker therapy and clinical outcomes following non-cardiac surgery, especially when used in combination with TEA. Preoperative β-blockade in the context of laparoscopic gastric-by-pass surgery have not shown any difference in postoperative morbidity or mortality [25]. The presence of adverse effects such as stroke or death following β-blocker treatment in surgical patients have been recorded [26].…”