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  3. 14. Can Unexpected Preoperative Hypertension be Managed by Reassurance and Anxiolytics and Avoid Postponement of Eye and ENT Surgeries?
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14. Can Unexpected Preoperative Hypertension be Managed by Reassurance and Anxiolytics and Avoid Postponement of Eye and ENT Surgeries?

Mohammad Mohsin Rana1, Sajid Rashid Nagra2, Muhammad Saleem Akhtar1, Danish Gani3, Zafar Iqbal Zafar3 and Nauman Khalid4

ABSTRACT

Objective: To highlight the fact that single preoperative high reading of Blood pressure doesn’t have any effect on the surgical outcome in non-cardiothoracic and major abdomino-thoracic surgeries. In common ENT and Eye surgeries this shall not be a reason for the postponement or delay in the procedures, most of these situations can be managed by reassurance and anxiolytics

Study Design: Observational cross section study

Place and Duration of Study: This study was conducted at the Rai Medical College Sargodha and Private Consultancies of the participants from Jan to June, 2022.

Materials and Methods: All subjects between 20-90 years of age of both sexes, presenting for pre-operative assessment before any planned Eye and ENT surgery were assessed by measuring their BP. If it was found to be above 140/90 mmHg, they were included in this study.

Results: Out of 288 patients, 25% (n 72) were found to have their BP above 140/90 mmHg. 42% (n 30) were known hypertensives, out of these 37% (n11) missed the morning dose of their antihypertensive medicine and were excluded from the study. Out of the remaining 61 when BP was rechecked after 30 minutes of reassurance and comfortable , stress free environment away from OT, 18 (29%)patients had BP reading below 140/90 mmHg.

Remaining 43 (70.49%) patients were given tablet Alprazolam 0.25 mg orally and reassured again. BP was checked after 1 hour. Majority 31 (72.5%) out of 43 responded to reassurance and anxiolytics and BP returned to below 140/90mmHg and were issued fitness for anesthesia and surgery. 12 patients didn’t responded and their BP remained above the limit of 140/90mmHg and their surgery was postponed. Their BP didn’t responded to either reassurance or anxiolytics.

Conclusion: A simple explanation and reassurance by hospital staff may be sufficient to smoothen the patient’s anxiety. Missed dose of routine antihypertensive medicines shall be given in cases where only regional or local anesthesia is planned.

Key Words: Hypertension, pre-operative hypertension, Eye and ENT surgery

Citation of article: Rana MM, Nagra SR, Akhtar MS, Gani D, Zafar ZI, Khalid N. Can Unexpected Preoperative Hypertension be managed by Reassurance and Anxiolytics and Avoid Postponement of Eye and ENT Surgeries? Med Forum 2022;33(12):56-60.