The Use of Propranolol in the Perioperative Period of Resectable Gastrointestinal Tumors

Exclusion Criteria14

• \) Pregnant or breastfeeding women, or women with pregnancy plans within six months; 2) Patients with absolute or relative contraindications to propranolol:
• Pathological sinus node syndrome;
• Sinus bradycardia (less than 60 beats/minute);
• First, second or third degree AV block;
• Resting blood pressure less than 100/60 mmHg;
• untreated pheochromocytoma;
• untreated thyroid disease;
• Patients on dihydropyridine or non-dihydropyridine calcium channel blockers (e.g., diltiazem, verapamil, nifedipine, amlodipine);
• Severe peripheral vascular disease (intermittent claudication);
• Patients on antiarrhythmic drugs (e.g., amiodarone, sotalol, digoxin);
• Patients with renal insufficiency (defined as creatinine clearance greater than 0.15 mmol/L);
• Patients with hepatic insufficiency: AST or ALT or ALP \> 2.5 times the upper limit of normal (ULN), bilirubin \> 1.5 times the ULN, ALP \> 2.5
• Patients using colistin, digoxin, rizatriptan, cimetidine, hydralazine, guanethidine, or ergotamine.
• Patients with a history of major depressive episodes; 3) Patients who have undergone surgery for GI tumors within the previous six months; 4) Patients receiving neoadjuvant chemotherapy prior to planned gastrointestinal tumor resection; 5) patients using conventional anxiolytic drugs (e.g. benzodiazepines), alpha-adrenergic agonists (e.g. colistin); 6) Patients using selective or non-selective β-adrenergic inhibitors (e.g., propranolol, metoprolol, atenolol, sotalol) within the last three months; 7) Patients with a history of stroke; 8) Patients with moderate or severe asthma, defined as requiring hospitalization or oral steroid therapy; (9) Those who, in the opinion of the physician, have other reasons for not being included in the treatment.