The authors deal with the complex pharmacological control of sympathetic activation in high risk patients in the risk for the perioperative myocardial ischemia. As the part of the perioperative myocardial protection the authors present ultrafast short-acting beta blocker esmolol (Brevibloc
). Its application, as the part of the complex myocardial protection, decreases incidence of the perioperative myocardial ischemia in patients with the abdominal aortic surgery.

        Key words: perioperative myocardial ischemia – abdominal aortic surgery, – perioperative control of sympathetic activation, – myocardial protection