6. Drug Administration: Atenolol Preop

How was the drug given? The drug was given in the same manner as in the ISIS study for acute myocardial infarctions. If an internist can give a beta blocker IV to a patient having an acute myocardial infarction, you can give a patient a beta blocker prior to surgery. The drug was given in the PACU (pre anesthesia care unit) just prior to surgery. The blood pressure and heart rate were measured. If the heart rate was greater than 55 beats per minute and the systolic blood pressure was greater than 100 mmHg, and there was no evidence of acute congestive heart failure, third degree heart block, or acute broncospasm then 5 mg of atenolol was given IV. We waited five minutes. If the heart rate was greater than 55 beats per minute and the systolic blood pressure was greater than 100 mmHg, and there was no evidence of acute congestive heart failure, third degree heart block, or acute broncospasm then a second dose of 5 mg of atenolol was given IV. Then the patient was taken to the operating room.

In PACU 30 minutes before going into OR:

	2 syringes labeled study drug (Atenolol 5 mg or Placebo)
	ECG on, BP recorded
	If HR > 55 bpm & SBP > 100 mmHg, no CHF, 3-RD HB, Acute Broncospasm then infuse syringe #1
	Wait 5 Minutes
	If HR > 55 bpm & SBP > 100 mmHg, no CHF, 3-RD HB, Acute Broncospasm then infuse syringe #2
	Go to OR