Management of Incidental Uncontrolled Elevation of Intraoperative Blood Pressure: A Comparative Study on Nitroglycerine Versus Dexmedetomidine Infusion

Walaa Y Elsabeeny; Nahla N Shehab; Mostafa A Ibrahim; Eman D El Desouky; Sayed M Abed

doi:10.5812/aapm-134806

Management of Incidental Uncontrolled Elevation of Intraoperative Blood Pressure: A Comparative Study on Nitroglycerine Versus Dexmedetomidine Infusion

Anesth Pain Med. 2023 Mar 10;13(2):e134806. doi: 10.5812/aapm-134806. eCollection 2023 Apr.

Authors

Walaa Y Elsabeeny¹, Nahla N Shehab¹, Mostafa A Ibrahim¹, Eman D El Desouky², Sayed M Abed¹

Affiliations

¹ Department of Anesthesia, Critical Care and Pain Management, National Cancer Institute, Cairo University, Cairo, Egypt.
² Department of Epidemiology and Biostatistics, National Cancer Institute, Cairo University, Cairo, Egypt.

Abstract

Background: Uncontrolled elevation of intraoperative blood pressure can result in deleterious effects with increased risk of morbidity and mortality.

Objectives: We aimed to compare nitroglycerine infusion with dexmedetomidine infusion in controlling accidental intraoperative uncontrolled hypertension.

Methods: This comparative study was conducted on 73 hypertensive patients undergoing cancer surgeries who experienced uncontrolled intraoperative hypertension. The data of 38 patients were retrieved from the medical records for the nitroglycerine group and 35 patients were prospectively enrolled for the dexmedetomidine group. Group N received nitroglycerine infusion (0.3 - 1 µg/kg/min), while group D received dexmedetomidine infusion (0.2 - 0.7 µg/kg/h).

Results: Both groups were comparable regarding their demographic data and clinical characteristics. Systolic, diastolic, and mean arterial pressure (MAP) values were significantly lower in group N compared to group D during the period between 60 and 120 minutes intraoperatively (P < 0.001). Heart rate values were significantly lower in group D than in group N (P < 0.001). Postoperative sedation scores were better for group D with lower analgesic requirements (P < 0.001).

Conclusions: Dexmedetomidine infusion can be used to manage the uncontrolled intraoperative elevation of blood pressure in selected patient population.

Keywords: Dexmedetomidine; Hypertension; Nitroglycerine; Surgery.