7. Drug Administration: Atenolol Post-op

In the PACU (post anesthesia care unit) after surgery, the dosing was repeated. 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. This IV dosing was continued every 12 hours until the patient could take oral medications. Then the dosing was shifted to Atenolol 100 mg PO QD if the heart rate was greater than 65 beats per minute and the systolic blood pressure was greater than 100 mmHg. If the heart rate was between 55 and 65 and the systolic blood pressure was greater than 100 mmHg, then Atenolol 50 mg PO was given. If the heart rate was below 55 beats per minute or the systolic blood pressure was below 100 mmHg, the atenolol dose was held. The atenolol dosing was continued for 7 days postoperatively.

In PACU After Surgery (repeat Preop Procedure)

	Repeat Preop Procedure q12 until able to take PO medications.
	Once on PO then HR > 65 bpm and SBP > 100 mmHg 100 Atenolol mg PO 55 < HR < 65 bpm and SBP > 100 mmHg Atenolol 50 mg PO HR < 55 bpm or SBP < 100 mmHg Hold Atenolol