Management of perioperative hypertension using sublingual nifedipine. Experience in elderly patients undergoing eye surgery.

Sublingual nifedipine was administered perioperatively to 19 elderly (age, greater than or equal to 60 years) patients undergoing ophthalmologic surgery. All of the patients had blood pressures exceeding 200 mm Hg systolic or 110 mm Hg diastolic, and 18 of the patients had both. Average (mean +/- SD) systolic blood pressure fell from 224.9 +/- 13.9 mm Hg to 154.6 +/- 19.0 mm Hg, while average diastolic blood pressure was reduced from 121.5 +/- 12.2 mm Hg to 78.1 +/- 10.6 mm Hg. Mean time to onset of response to nifedipine was 9.47 +/- 3.9 minutes, while the maximum antihypertensive response occurred in 35.3 +/- 10.2 minutes. A prompt antihypertensive response was obtained without any serious side effects. To our knowledge, this is the first reported study demonstrating the efficacy and safety of using sublingual nifedipine for the management of perioperative hypertension.