Perioperative interventions to modify risk of morbidity and mortality

Perioperative myocardial ischemia is the single most important, potentially reversible risk factor for mortality and cardiovascular complications during and after noncardiac surgery. The influence of anesthetic choices and techniques on cardiac risk in noncardiac surgery is difficult to ascertain because of the low incidence of morbid cardiac outcomes in the surgical population as a whole. This article summarizes several areas (eg, perioperative β-blockade, glucose management, and perioperative hemodynamics) that have been addressed in well-designed clinical trials.