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Does Combined Spinal Epidural Anesthesia Decrease the Morbidity of Iliac Block Bone Grafting for Deficient Alveolar

Erol Cansiz1, B Alper Gultekin2, Tolga Sitilci1

  • 1Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|July 12, 2016
PubMed
Summary

Combined spinal epidural anesthesia (CSEA) offers improved patient comfort for iliac block bone grafting compared to general anesthesia (GA). CSEA reduces pain, vomiting, and hospitalization, leading to faster recovery.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Anesthesiology
  • Regenerative Medicine

Background:

  • Iliac block bone grafting is a common procedure for reconstructing deficient maxillary alveolar ridges.
  • Anesthetic technique selection impacts patient morbidity and recovery outcomes.

Purpose of the Study:

  • To compare the morbidity associated with iliac block bone grafting under general anesthesia (GA) versus combined spinal epidural anesthesia (CSEA).

Main Methods:

  • Retrospective study of 22 patients undergoing anterior iliac block bone grafting.
  • Comparison of outcomes including pain, gait disturbance, neurosensory disturbance, vomiting, and hospitalization duration based on anesthetic technique (GA vs. CSEA).

Main Results:

  • The general anesthesia group reported significantly higher pain, gait disturbance at 3 weeks, and vomiting on the day of surgery compared to the CSEA group.
  • Postoperative hospitalization was significantly longer in the general anesthesia group.
  • No significant difference in neurosensory disturbance was observed between the groups.

Conclusions:

  • Both general anesthesia and combined spinal epidural anesthesia are viable for iliac block bone grafting.
  • Combined spinal epidural anesthesia demonstrates superior patient comfort due to reduced pain and vomiting, facilitating earlier recovery.