Controlled Hypotension Effect Of Drugs On A Rise In Blood Pressure Of Patients With Hypertension During Tooth Extraction

Tooth extraction of patients with hypertension has been increasing. The fear of painoften leads to psychological stress and high blood pressure, particularly in patients withhypertension. The extremely rise of blood pressure directly has a bad effect on the securityof the tooth extraction surgery, and then increase the risk of cardiovascular accidents. Howto ensure the security of patients with hypertension during tooth extraction is a bigchallenge.In this research, data about controlled hypotension medication on patients withhypertension during tooth extraction from January1997to December2011in our hospitalwere collected and analyzed retrospectively. Then a randomized double-blind, clinicalstudy was carried to compare controlled hypotension effect by different drugs.The study was divided into two parts:A retrospectively study The blood pressure of patients with hypertension was controlled hypotension bydifferent oral medication from January1997to December2011in our department. Thedata on blood pressure and heart rate before and after medication were collected and thestatistical analysis was made on drug use, and blood pressure level.The results showed:1.The number of patients with blood pressure monitoring during tooth extraction andthe patients undergoing controlled hypotension have been increased year by year.2.The changes on blood pressure in each group were statistically significant after themedication. Blood pressure fluctuates in a small range before and after anesthesia,intraoperative and postoperative.3.Diazepam and combined application of nifedipine and diazepam had goodhypotension effect. The effect was statistically significant in patients of hypertension3-class, men and over75-year-old in diazepam group and in patients of hypertension2,3-class, female and over75-year-old in combined application of nifedipine and diazepamgroup.4.The patients having controlled hypotension medication during tooth extraction wasmainly above60-year-old. The older the people, the more obvious hypotension effect theyhad except in nifedipine group. Patients above75-year-old had a statistically significanceon decreased effect on Systolic Blood Pressure (SBP).A prospectively studyIn a randomized and double-blind study from March2012to March2013, ninetypatients with hypertension undergoing controlled hypotention medication were givendifferent drugs, such as diazepam, nifedipine and diazepam combined with nifedipine.Blood pressure and heart rate during extraction were recorded in detail. The comparativeanalysis on hypotesion effect was made in different groups. The extraction difficulty andextraction time on blood pressure and heart rate were also analyzed.The results showed:1.After controlled hypotension medication, the level of hypertension patients met therequirements of tooth extraction, and changes of perioperative blood pressure and heart rate was relatively stable after controlled hypotension medication.2.Blood pressure decreased significantly in diazepam combined with nifedipinegroup than diazepam group and nifedipine group.3.Difficulty and time during tooth extraction affect significant changes in bloodpressure.In brief, controlled hypotension medication has some limitations; however, it is stillan effective way to ensure the safety of patients with hypertension in tooth extraction,reducing the risk of cardiovascular accidents perioperation.