Blood pressure correction during analgosedation of adults undergoing dental treatment
DOI:
https://doi.org/10.33295/1992-576X-2021-5-12Keywords:
blood pressure, hypertension, dental treatment, analgosedation, adultsAbstract
The aim is to assess the need and possibilities of blood pressure correction in adults with hypertension during dental treatment under analgosedation.
Methodology. Monitoring of blood pressure before, during and after dental treatment under analgosedation for adults aged 18–93 years (ASA I–III): 890 men and 760 women. A total of 1650 events of propofol-based analgosedation have been documented. 248 patients (15 %) had confirmed hypertension. Nifedipine, magnesium sulfate, benzohexonium or urapidil (ebrantil) were used for correction.
Results. Immediately before surgery, an increase in blood pressure was observed in 75% of all patients by 10–40 % of baseline. After the start of analgosedation after 10 min, normalization of blood pressure to baseline was observed in 90 % of patients aged 18–60 and in 70 % of the group «60+». However, in 10 % of patients 18–60 y. o. and in 30% of patients of group «60+» remained greater than 150/100 mm Hg. 462 patients (28 %) required antihypertensive agents.
Conclusions. 1) Blood pressure is an important physiological parameter in the analgosedation of adults in dentistry; its monitoring allows to detect undiagnosed hypertension.2) Increased blood pressure before dental treatment under analgosedation is observed in people aged 18-40 years with the highest level of anxiety and in people with hypertension. 3) Local anesthesia leads to an immediate increase in blood pressure in 70% of patients. Self-decreasing of blood pressure occurs in 3–10 minutes in most patients. 4) The use of nifеdipine; magnesium sulfate, benzohexonium and uropidyl are effective in lowering blood pressure. 5) Carrying out analgosedation during dental treatment prevents a significant increase in blood pressure, promotes postoperative pain-relieving and positive mood of the patient.
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