الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
For stage 1 and stage 2 preoperative hypertension, guidelines are quite sharp and there is general agreement that these 2 stages are not an independent risk factor for perioperative cardiovascular complications. On the contrary guidelines for stage 3 preoperative hypertension are still vague and not clear enough. For that reason we decided to conduct a prospective, randomized, controlled study among patients presented for orthopedic surgery with stage 3 hypertension. This study was carried out on 120 patients who were randomly divided into 2 major groups via sealed envelope assignment: Group A (study group) included patients whose blood pressure was going to be managed acutely within 6 hours. Those patients were further subdivided into 2 subgroups, group Aat ,the patients of this group received atenolol 100 mg tablet, and group Anf the patients of which received nifedipine retard 20 mg tablet. Patients of Aat and Anf groups then had their blood pressure reduced over the following 6 hours by nitroglycerin IV infusion. C (control group) included patients whose surgery was postponed until their blood pressure was controlled. A standard anesthetic protocol was used in all patients. In the current study, rapid control was shown to be as safe as its comparator conventional slow control for the management of stage 3 preoperative hypertension based on absence of significant difference in the primary outcome of the hemodynamic changes, dysrhythmia, myocardial ischemia, MI, renal dysfunction, neurologic dysfunction and perioperative blood losses. However we did observe a significant increase in the period of hospitalization in the control group compared with the two acutely managed groups. Also there was a significant decrease in both total nitroglycerin dose (TND) and mean (MND) in the control group compared with the two acutely managed groups.