Comparison between sublingual nifedipine and intravenous clonidine to control perioperative arterial hypertension in cataract procedures

Abstract

Background and Objectives - A recent study has shown that intravenous clonidine is effective and safe in treating perioperative arterial hypertension during cataract procedures. This study aimed at comparing sublingual nifedipine and intravenous clonidine to control arterial hypertension during cataract procedures. Methods - Participated in this randomized double-blind study 75 patients submitted to facectomy, who were distributed in: Group A, receiving nifedipine and Groups C2 and C3, receiving 2 and 3 μg.kg-1 intravenous clonidine, respectively. All patients had arterial hypertension (SBP > 170 mmHg or DBP > 110 mmHg). SBP, DBP and HR were monitored and compared in moments 0 (before treatment), and at 2-minute intervals until the end of the procedure. Adverse events were recorded. Results - There has been SBP and DBP decrease in all groups after treatment (p < 0.001). There has been blood pressure control (< 160 mmHg) in 32%, 64% and 72% of groups A, C2 and C3 patients, respectively (p < 0.05). Group C3 presented a higher incidence of side-effects, as compared to groups C2 and A (p < 0.05). Conclusions - Intravenous clonidine is more effective than sublingual nifedipine to control perioperative arterial hypertension during cataract extraction. However, the dose of 3 μg.kg-1 may be related to side-effects and treatment should be started with 2 μg.kg-1.