From the Research
Beta blockers are not typically used in the treatment of varicella (chickenpox) associated bleeding, as the provided evidence does not support their use in this context. The question appears to be related to variceal bleeding, which is a complication of cirrhosis, rather than varicella (chickenpox) associated bleeding. In the context of variceal bleeding, beta blockers, such as propranolol or nadolol, are recommended to reduce portal pressure and decrease the risk of rebleeding 1. They work by decreasing cardiac output and causing splanchnic vasoconstriction, which reduces portal blood flow and pressure, helping to prevent further bleeding from esophageal varices 2. Important considerations include:
- Monitoring heart rate and blood pressure, aiming for a 25% reduction in heart rate
- Avoiding use in patients with severe heart failure, heart block, or asthma
- Combining with endoscopic band ligation for optimal prevention of rebleeding
- Continuing beta blockers even after eradication of varices, as they reduce overall portal pressure However, it is essential to note that the provided evidence does not support the use of beta blockers in varicella (chickenpox) associated bleeding, and their use in this context is not recommended. The most recent and highest quality study, a network meta-analysis from 2021, provides evidence on the use of beta blockers in variceal bleeding, but not in varicella (chickenpox) associated bleeding 1. Therefore, beta blockers should not be used to treat varicella (chickenpox) associated bleeding, and alternative treatments should be considered.