Objective. To evaluate the effects of perioperative ƒÀ blockers
versus placebo.
Design. Prospective, multicenter, randomized, placebocontrolled
trial.
Setting and participants. 8351 patients aged . 45 years with
or at risk for atherosclerotic disease who were undergoing
noncardiac surgery were randomized by computerized
phone randomization to either extended-release metoprolol
(n = 4174) or placebo (n = 4177). Participants received
extended-release metoprolol 100 mg or matching placebo
2 to 4 hours before surgery. The first postoperative dose
(100 mg or placebo) was given 6 hours after surgery or sooner
if the heart rate was . 80 bpm or systolic blood pressure was
. 100 mm Hg. Patients started oral extended-release metoprolol
200 mg or placebo 12 hours after the first postoperative
dose and continued the medication daily for 30 days.