Assessment of the impact of closed sinus lift on changes in the autonomic nervous system in the early postoperative period; [评估封闭式鼻窦提升术对术后早期自主神经系统变化的影响]; [Оценка влияния закрытого синус-лифтинга на изменения вегетативной нервной системы в раннем послеоперационном периоде]

Objective: to study changes in the autonomic nervous system in patients after closed sinus lift with simultaneous dental implantation based on the analysis of heart rate variability. Material and methods. Ninety-three patients underwent sinus lifting with simultaneous dental implantation. Depending on the prescribed NSAID, patients were randomly divided into 3 groups. Group 1 (32 patients) received a selective cyclooxygenase-2 (COX-2) inhibitor from the coxib class - etoricoxib (60 mg); group 2 was prescribed a sulfonamide derivative, a selective inhibitor of COX-2 with a low inhibitory effect on COX-1 - nimesulide (100 mg), and group 3 received a non-selective inhibitor of COX-1 and COX-2 - ketorol (10 mg). All drugs were administered orally 1 hour, 24 hours, and 48 hours after the end of the manipulations. Using the electrocardiographic (ECG) analysis of heart rate variability (HRV), we assessed VLF (ms2) - very low-frequency component, HF (ms2) - high-frequency component of the heart rate, LF (ms2) - low-frequency component, and LF/HF - vagosympathetic index. Results. The eterocoxib group had the most favorable dynamics of the HRV parameters. In particular, these patients did not demonstrate centralization of the cardiac activity regulation, which is reflected by VLF, and had a less pronounced sympathetic tone (a decrease in the low-frequency spectrum of HRV and an increase in HF), which is confirmed by a lower vagosympathetic index as compared with the other groups. Conclusions. The use of modern non-steroidal anti-inflammatory drugs, such as selective COX-2 blockers, leads to a decrease in the response of the autonomic nervous system to surgical damage during sinus lift with simultaneous dental implantation. © Team of authors, 2022