To the Editor.
—As an anesthesiologist in a freestanding ophthalmologic surgery center, I have administered approximately 12 500 peribulbar blocks to patients undergoing cataract surgery during the past 5 years. In my practice, hypertension is a frequently encountered problem (nearly half of my patients are taking medications for hypertension) that I cannot leave untreated. Because of potentially devastating hemorrhagic complications that may accompany peribulbar blocks and intraocular surgery, it is not prudent to begin surgical treatment until the patient's blood pressure is under control. Because more than 90% of the patients with hypertension whom I manage have had blood pressures recorded in the normal range in their physicians' offices during their preoperative evaluations, I cannot justify sending them back to their physicians for more aggressive treatment. Consequently, I have administered oral nifedipine (5-10 mg) to nearly 30% of my patients to maintain their systolic blood pressures at less than 170 mm Hg prior
Fanning GL. Nifedipine for Hypertensive Emergencies. JAMA. 1997;277(10):789-790. doi:10.1001/jama.1997.03540340023019