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Antihypertensive therapy with beta adrenergic antagonists is required regardless of medical versus surgical treatment.
Another example of anaesthetic premedication is the preoperative administration of beta adrenergic antagonists to reduce the incidence of postoperative hypertension, cardiac dysrhythmia or myocardial infarction.
This is an inaccurate way of determining patient comfort under the effects of paralysis, and may be unreliable in ICU patients on medications like beta adrenergic antagonists to control heart rate, and sympathomimetic drugs such as dopamine or dobutamine to support hemodynamics.
Since beta blockers are known to relax the cardiac muscle and to constrict the smooth muscle, these beta adrenergic antagonists, including propranolol, have an additive effect with other drugs which decrease blood pressure, or which decrease cardiac contractility or conductivity.