title: Efficacy of intravenous sedation and oral nifedipine in dental implant patients with preoperative hypertension - a retrospective study of 516 cases.
abstract: BACKGROUND
  To examine the effects of intravenous sedation and oral nifedipine on blood pressure and pulse rate in patients with perioperative high blood pressure undergoing implant surgery, the clinical records of dental implant patients managed by intravenous sedation at our outpatient dental offices were retrospectively evaluated.
  
  
  METHODS
  A total of 516 clinical charts were evaluated. The subjects were divided into two groups: a normotensive group with no history of hypertension and a hypertensive group with a history of hypertension. The patients in the hypertensive group were further divided into two subgroups: with or without nifedipine administration before operation. Systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse rate (PR), and rate pressure product (RPP) were assessed.
  
  
  RESULTS
  In 30 patients (33%) of the hypertensive group, the high blood pressure on arrival obviously declined to around or less than 160 mmHg; in the remaining patients in the group who showed a mean SBP of 182.1 ± 13.8 mmHg on arrival, the blood pressure did not decrease after a 30-min rest. Oral nifedipine administered to the patients with sustained high blood pressure decreased SBP to 144.7 ± 23.1 mmHg in 28.1 ± 9.3 min after administration, comparable to that in hypertensive patients without nifedipine.
  
  
  CONCLUSIONS
  For patients with stage 2 hypertension before operation, it may be difficult to maintain the recommended blood pressure during surgery by only intravenous sedation; reduction of blood pressure by antihypertensive drugs may be necessary.
authors.affiliation: Hanano Dental Clinic, 4-2-3 Yamanoue, Hirakata, Osaka, 573-0047, Japan. kimkimkim0719@yahoo.co.jp.
authors.forename: Motoshi
authors.initials: M
authors.lastname: Kimura
authors.affiliation: Department of Anesthesiology, Kinki University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Takasugi
authors.affiliation: Hanano Dental Clinic, 4-2-3 Yamanoue, Hirakata, Osaka, 573-0047, Japan.
authors.forename: Shigeyoshi
authors.initials: S
authors.lastname: Hanano
authors.affiliation: Terabe Dental Clinic, 4-249 Sakae-cho, Tsu, Mie, 514-0004, Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Terabe
authors.affiliation: First Department of Internal Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kimura
keywords: Dental implant; Hemodynamics; Intravenous sedation; Nifedipine administration; Oral surgery