beta blocker and surgery

Dear Doctor:

I am a 32 year old male.I may have to undergo surgery for the fourth time for a paraesophageal hernia. It will be a thorocotomy. I take 100mg/day of Lopressor for palpitations (PVC's,PAC's).  During my last surgery four months ago, they tried to give me my meds through my NG tube and the Surgeon thought it wasn't being absorbed by my stomach and he discontinued my meds until the tube was removed several days later. My heart rate was anywhere from
100-122 until they removed the NG tube and I started taking my meds again. Then my heart rate went right back down in the 70-80
range. My questions are   1)is it safe to discontinue the lopressor like that? 2) Is it safe to be on a beta blocker going into surgery?    Thank you for your help.


     -Erik

[Cleveland Clinic, MD]

Dear Erik,
While it is probably OK to suddenly stop beta-blockers in a young person like yourself it is probably not the best thing to do.  The body becomes "accustomed" to having beta-blockers in the system so when they are stopped suddenly there is a reflex increase in heart rate.  So in general we recommend to people tocome off beta-blockers gradually.  It is safe to be on beta-blockers during surgery but they should be continued post-op.  They can be given iv if there is a problem with taking oral meds.