Key result
Nitroglycerine infusion achieved significantly lower intraoperative blood pressure than dexmedetomidine (P<0.001), though dexmedetomidine resulted in lower heart rates and better sedation scores.
Why the study?
Uncontrolled intraoperative blood pressure elevation can cause deleterious effects with increased morbidity and mortality, prompting a comparison between nitroglycerine and dexmedetomidine infusions.
Does dexmedetomidine infusion improve intraoperative blood pressure control and postoperative outcomes compared to nitroglycerine infusion in hypertensive patients undergoing cancer surgeries?
Cohort (n=73)
Does dexmedetomidine infusion improve intraoperative blood pressure control and postoperative outcomes compared to nitroglycerine infusion in hypertensive patients undergoing cancer surgeries?
p-value: p=<0.001
Dexmedetomidine and nitroglycerine are both effective for controlling intraoperative hypertension, but dexmedetomidine offers better heart rate control, less rebound hypertension, and improved postoperative sedation and analgesia, despite a higher risk of bradycardia.
Nitroglycerine was associated with lower BP while dexmedetomidine improved HR and sedation; hypothesis-generating and requires randomized confirmation.
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.
No takes yet. Share an insight, caveat, or question.
Elsabeeny et al. (2023) conducted a cohort in Uncontrolled intraoperative hypertension (n=73). Dexmedetomidine infusion vs. Nitroglycerine infusion was evaluated on Systolic, diastolic, and mean arterial pressure (MAP) between 60 and 120 minutes intraoperatively (p=<0.001). Nitroglycerine infusion achieved significantly lower intraoperative blood pressure than dexmedetomidine (P<0.001), though dexmedetomidine resulted in lower heart rates and better sedation scores.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: