Correlation and comparison of body mass index on hemodynamics in hypertensive and normotensive patients undergoing intravenous sedation.
OBJECTIVE
The purpose of this project was to retrospectively compare and correlate body mass index (BMI) and hemodynamics in hypertensive and normotensive patients undergoing intravenous sedation for dentoalveolar surgery.


METHODS
A retrospective chart analysis of 263 consecutive male patients undergoing intravenous (IV) sedation for dentoalveolar surgery was divided into 5 BMI groups: underweight, normal weight, overweight, obese, extremely obese. Data recorded were noninvasive baseline and intraoperative hemodynamic measurements at 5-minute intervals for systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse pressure (PP), and pulse (P). Statistical analysis of mean values between groups was carried out using multivariate linear regression analysis, Pearson's correlation coefficient, and Student's t test and found significant for P < .05.


RESULTS
Average hemodynamic values for normotensive patients were significantly lower for all groups except for pulse in the normal group, pulse in the obese group, and DBP in the extremely obese group. For normotensive patients, there were statistically significant strong positive correlation for elevated BMI and increased baseline changes in SBP and PP. For the hypertensive group, there was a statistically significant moderate positive correlation for elevated BMI and increased baseline changes in PP and statistically significant strong positive correlation for baseline changes in MAP. Baseline changes were significant for greater increases in SBP and decreases in DBP and MAP in the underweight hypertensive group. Significant increases from baseline in the normotensive group were for PP in the normal BMI group and for pulse in the obese group. All baseline changes, with the exception of normotensive underweight SBP (+26.7%) and hypertensive PP (+23.9%), were within +/-20% of baseline (range, -12.2% to +17.4%).


CONCLUSIONS
In general, normotensive patients in this study had lower average hemodynamic values than hypertensive patients in all BMI groups. Great variability was seen in baseline changes for all BMI groups, but a substantial majority of changes were within +/-20% of baseline. There were statistically significant moderate and positive correlations in BMI for changes from baseline for several hemodynamic measurements. Intravenous sedation for oral and maxillofacial surgery procedures maintains a stable hemodynamic state in hypertensive and normotensive patients regardless of BMI.
Oral and Maxillofacial Surgery, Parkland Memorial Hospital/University of Texas Southwestern Medical Center, Dallas, TX 75235-5310, USA. jecdna@aol.com
Joseph E
JE
Cillo
Richard
R
Finn
D000328:Adult; D000766:Anesthesia, Dental / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D001794:Blood Pressure / Q000187:drug effects*; D015992:Body Mass Index; D016292:Procedural Sedation; D005283:Fentanyl / Q000008:administration & dosage; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D016014:Linear Models; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D016343:Monitoring, Intraoperative; D009765:Obesity / Q000503:physiopathology*; D019647:Oral Surgical Procedures; D015742:Propofol / Q000008:administration & dosage; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013851:Thinness / Q000503:physiopathology
D018686:Anesthetics, Intravenous; D008874:Midazolam; D005283:Fentanyl; D015742:Propofol