This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Brown, D. R. Articles by Brown, M. J. Search for Related Content PubMed PubMed Citation Articles by Brown, D. R. Articles by Brown, M. J. Related Collections Preoperative Evaluation Pharmacology

---

ANESTHETIC PHARMACOLOGY

Hypoglycemia Associated with Preoperative Metoprolol Administration

Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota

Address correspondence to Daniel R. Brown, MD, PhD, Department of Anesthesiology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905. Address e-mail to brown.daniel{at}mayo.edu

Perioperative ß₁-selective-adrenergic antagonist administration has been shown to decrease morbidity and mortality in patients with cardiac disease undergoing surgical procedures. We report a case of a patient receiving the selective ß₁-adrenergic antagonist, metoprolol, immediately before surgery that was associated with severe hypoglycemia. We postulate that an underlying abnormality in energy requirements or metabolism may allow for ß₁-selective-adrenergic antagonists to precipitate hypoglycemia.

IMPLICATIONS: In patients with abnormal energy metabolism, which may occur with cancer, or a history of unexplained hypoglycemia, care must be taken to ensure that hypoglycemia does not occur when ß-adrenergic antagonists are administered.