Does combined spinal epidural anesthesia decrease the morbidity of iliac block bone grafting for deficient alveolar ridges compared with general anesthesia?

Abstract Purpose To evaluate the morbidity of iliac block bone grafting performed under general anesthesia (GA) or combined spinal epidural anesthesia (CSEA). Methods The investigators implemented a retrospective study including patients who underwent anterior iliac block bone grafting for deficient maxillary alveolar ridges. The anesthetic technique (GA or CSEA) was the primary predictor variable. The outcome variables were pain, gait disturbance, neurosensory disturbance (0 to 5 weeks), vomiting tendency (0 to 7 days), and postoperative hospitalization period (0 to 2 days). Results The sample comprised 22 patients grouped as follows: GA (n = 10) and CSEA (n = 12). No surgical complications except sensory disturbance in two patients were observed during the study period. Pain during initial healing ( P < .001), the gait disturbance rate at 3 weeks after surgery ( P = .003), and the vomiting tendency on the day of surgery ( P < .001) were significantly higher in the GA group than in the CSEA group; all variables showed significant improvement with time in both groups. The postoperative hospitalization period was also significantly longer for the GA group than for the CSEA group (P < .001). No significant difference was observed between groups with regard to neurosensory disturbance. Conclusions Iliac block bone grafting for deficient maxillary ridges can be successful under both GA and CSEA, although CSEA results in less pain and vomiting and early recovery, thus increasing patient comfort.