Background: Transfers of patient care and responsibility among caregivers,“handovers,” are
common. Whether handovers worsen patient outcome remains unclear. The authors tested
the hypothesis that intraoperative care transitions among anesthesia providers are
associated with postoperative complications. Methods: From the records of 138,932 adult
Cleveland Clinic (Cleveland, Ohio) surgical patients, the authors assessed the association
between total number of anesthesia handovers during a case and an adjusted collapsed …

In previous trials, metoprolol succinate, a nonselective β-blocker, reduced the risk of
perioperative myocardial infarction, but it doubled the incidence of postoperative stroke and
increased mortality. This was confirmed in studies that examined metoprolol tartrate and
succinate or atenolol. The less selective β-antagonists could impair the adaptive responses
to perioperative blood loss that include increases in cardiac output, cerebral blood flow, and
cerebrovascular dilatation. Using data from experimental studies in rat models, this current …