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Manejo de crisis hipertensiva en cirugía maxilofacial. Reporte de caso clínico
Hypertensive crisis management in maxillofacial surgery. Clinical case report
DOI:
https://doi.org/10.15446/aoc.v13n1.103325Keywords:
hipertensión, urgencia médica, antihipertensivos, complicaciones intraoperatorias, cirugía bucal (es)Hypertension, Medical urgency, Antihypertensives, Intraoperative , complications, Oral surgery (en)
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Introducción: un aumento marcado de la tensión arterial puede llevar a una crisis hipertensiva, que consiste en una elevación considerable de la tensión arterial (>180 mmHg en sístole y >120 mmHg en diástole). De no ser tratada, puede llevar a la pérdida progresiva de la conciencia, así como provocar daños irreversibles a algún órgano blanco, por ejemplo, el hígado, el riñón o el cerebro. Se puede clasificar en urgencia o emergencia hipertensiva. Así, una urgencia hipertensiva se presenta cuando el paciente cuenta con cifras elevadas en la tensión arterial sin provocar daño a un órgano blanco y, en contraparte, una emergencia hipertensiva cumple con las cifras que se mencionaron, pero incluye daño a un órgano blanco. Objetivo: presentar un caso clínico, en el cual, durante la extracción quirúrgica de una aguja fracturada, en el período transoperatorio, el paciente sufre síncope vasovagal, con un aumento marcado de la tensión arterial (179/119 mmHg). Conclusión: este fue un diagnóstico intraoperatorio de crisis hipertensiva y la paciente recibió un tratamiento médico temprano por parte del servicio de urgencias médicas, lo cual resultó en una evolución trans y postoperatoria adecuada.
A marked increase in blood pressure can lead to a hypertensive crisis, it can be classified as an urgency or hypertensive emergency, which consists of a considerable increase in blood pressure (> 180 mmHg in systole and> 120 mmHg in diastole) and that, not being treated can lead to progressive loss of consciousness, as well as cause irreversible damage to the liver, kidney or brain. The objective of this article is to present a clinical case that during the surgical extraction of a fractured needle, in the intraoperative period the patient suffers vasovagal syncope, with a marked increase in blood pressure (179/119 mmHg), intraoperative diagnosis of crisis hypertensive, receiving early medical treatment from the emergency medical service, resulting in an adequate trans and postoperative evolution.
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