Perioperative use of beta-blockers in vascular and endovascular surgery

Editor—I thank Drs Bolsin and Conroy¹ for raising their concerns regarding a recent publication by Hajibandeh and colleagues² in the British Journal of Anaesthesia. There is no doubt that the role of perioperative beta-blockade has come under close scrutiny since the 1990s,³⁴ but it is misleading to describe the conclusions of the trial by Mangano and colleagues⁵ as 'baseless' despite there being some legitimate criticisms of its design and interpretation. The Mangano data have been used by others in other systematic reviews.⁶⁷ We agree that data derived from the DECREASE trials are unreliable.

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