title: A comparison of cardiac rate-pressure product and pressure-rate quotient in healthy and medically compromised patients.
abstract: Healthy and medically compromised patients were studied to compare blood pressure and heart rate changes in response to stress of routine dental extractions performed while they were under local anesthesia. Thirty-nine patients divided into American Society of Anesthesiologists (ASA) I and II groups were noninvasively monitored every 5 minutes. Systolic, diastolic, and mean arterial pressures and heart rate were recorded. Rate pressure products (RPP) and pressure rate (PRQ) quotients were calculated and compared in each group. Significant results were measures of RPP greater than 12,000 and PRQ less than one. Of the 24 patients in the ASA I category, 50% demonstrated elevated RPP values, but only two of 24 had coincidental PRQ abnormalities. Of the 15 patients in the ASA II category, 80% demonstrated elevated RPP values, but two of 15 had coincidental PRQ abnormalities. Patients in the ASA II category had a higher incidence of RPP and PRQ abnormalities, as was expected. However, it is not known which of these two measures is a more sensitive indicator of increased risk associated with stimulation of the sympathetic-adrenergic axis during oral surgery performed with patients under local anesthesia. Correlation studies with continuous Holter monitoring for ST-T wave changes on electrocardiography are forthcoming.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Medical College of Virginia, Richmond, USA.
authors.forename: R L
authors.initials: RL
authors.lastname: Campbell
authors.forename: W G
authors.initials: WG
authors.lastname: Langston
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000766:Anesthesia, Dental / Q000009:adverse effects; D000772:Anesthesia, Local / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects; D001795:Blood Pressure Determination / Q000379:methods; D002318:Cardiovascular Diseases / Q000503:physiopathology*; D017742:Dental Care for Chronically Ill / Q000379:methods*; D003920:Diabetes Mellitus / Q000503:physiopathology; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000209:etiology; D012016:Reference Values; D012189:Retrospective Studies; D013312:Stress, Physiological; D013599:Systole; D014081:Tooth Extraction; D014662:Vasoconstrictor Agents / Q000494:pharmacology; D014666:Vasomotor System / Q000187:drug effects / Q000503:physiopathology
chemical_list: D014662:Vasoconstrictor Agents