Effect of Nitroglycerin Patch and Sublingual Administration of Nifedipine in Postoperative Hypertension.

After surgery, blood pressure tends to increase due to psychological and physical stress, such as anxiety and pain. In patients with hypertension and cardiovascular disease, this increase in blood pressure is more marked and sometimes leads to serious systemic complications. Therefore, the need for careful attention to postoperative blood pressure management to prevent complications following surgery has been recognized. In the present study, we investigated whether a nitroglycerin patch and the sublingual administration of nifedipine were effective treatment modalities for the management of postoperative hypertension and also evaluated their usefulness. Twenty-nine patients who developed postoperative hypertension after digestive tract surgery were studied.The results obtained were as follows.1. From 2 to 12 hours after the administration of a nitroglycerin patch, the systolic blood pressure decreased significantly. However, 54 % of the patients demonstrated a systolic blood pressure of greater than or equal to 180 mmHg after the administration of nitroglycerin patch.2. The sublingual administration of nifedipine caused significant decreases in the systolic blood pressure, diastolic blood pressure and mean arterial pressure.3. As a result of the multiple regression analysis, the mean arterial pressure after administration of nifedipine showed negative correlation with dose of nifedipine and age, while the mean arterial pressure before the administration of nifedipine are positively correlated.As a result, the use of a nitroglycerin patch was not found to effectively control blood pressure. The sublingual administration of nifedipine, however, was found to effectively reduce blood pressure. These findings may have important clinical implications in the management of postoperative hypertension.