Effect of Local Anesthesia at the Bone Collection Site of Iliac Bone Grafting on Autonomic Nervous System Activity and Circulatory Dynamics in Alveolar Cleft Treatment.

BACKGROUND

In alveolar bone graft surgery, local administration of ropivacaine at the iliac bone donor site is expected to have an analgesic effect. However, its effects on autonomic nervous system activity and circulatory dynamics are unknown.

AIMS: This study aimed to assess the effects of local ropivacaine administration to the iliac region under general anesthesia by analyzing changes in autonomic nervous system activity and circulatory dynamics.

METHODS

We retrospectively reviewed medical records of patients who underwent iliac bone grafting under general anesthesia between May 2021 and December 2022. At the end of surgery, ropivacaine was administered locally in the iliac region. Heart rate variability (HRV), heart rate (HR), and systolic blood pressure (SBP) were analyzed 5 min prior to (baseline) and 5 min following (postadministration) ropivacaine administration.

RESULTS

Seventeen patients were included in the analysis. The low/high frequency ratio was significantly elevated after ropivacaine administration compared with baseline (p < 0.05). No significant changes were observed in high frequency, HR, or SBP (p < 0.05).

CONCLUSION

Local administration of ropivacaine in the iliac region under general anesthesia resulted in detectable neurological changes, as evidenced by HRV analysis, though conventional circulatory parameters remained unchanged. HRV may provide sensitive detection of perioperative stress beyond what is captured by hemodynamic measures alone.