Upto what levels of systolic and diastolic blood pressures ambulatory oral surgical care can be safely given?

# Upto what levels of systolic and diastolic blood pressures ambulatory oral surgical care can be safely given?

A. Systolic 120 and diastolic 80 mm of Hg

B. Systolic 140 and diastolic 90 mm of Hg

C. Systolic 160 and diastolic 100 mm of Hg

D. Systolic 200 and diastolic 110 mm of Hg

The correct answer is D. Systolic 200 and diastolic 110 mm of Hg.

Mild or moderate hypertension  (i.e., systolic pressure <200 mm Hg or diastolic pressure <110 mm Hg) is usually not a problem in the performance of  ambulatory oral surgical care, as long as the patient is not having  signs or symptoms of end-organ involvement secondary to the elevated blood pressure. Care of the poorly controlled hypertensive patient includes use of an anxiety-reduction protocol and monitoring of vital signs. 

Epinephrine-containing local anesthetics should be used cautiously; after surgery, patients should be advised to seek medical care for their hypertension. Elective oral surgery for patients with severe hypertension (i.e., systolic pressure of ≥200 mm Hg or diastolic pressure of ≥110 mm Hg) should be postponed until the pressure is better controlled. Emergency oral surgery in severely hypertensive patients should be performed in a well-controlled environment or in the hospital so that the patient can be carefully monitored during surgery and acute blood pressure control can be subsequently arranged.

Ref: Contemporary Oral and Maxillofacial Surgery, 7th Edition, Hupp, Tucker, Ellis, Page 13

End organ damage in case of hypertensive patients could be any one of the following. Signs and symptoms for each of these should be evaluated prior to surgical care. 

 

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