Abstract
OBJECTIVE: This study aims to investigate the effect of noise generated by ultrasonic bone scalpels (UBS) on cardiovascular stress responses in patients undergoing sinus floor elevation. METHODS: A retrospective analysis was conducted on clinical data from 120 patients requiring sinus floor elevation at our institution between February 2024 and February 2025. Participants were stratified into two groups based on surgical instrumentation: a UBS group (n = 60) and a conventional instrumentation group (n = 60). Intraoperative peak noise levels, heart rate variability indices, hemodynamic parameters, stress hormone concentrations, and anxiety scores were compared between groups. RESULTS: The UBS group showed significantly lower peak noise levels and shorter durations of high-intensity noise (P < 0.05) than the conventional instrumentation group. The decreases in the root mean square of successive normal-to-normal intervals (rMSSD) and standard deviation of all normal R-R intervals, as well as the increases in systolic/diastolic blood pressure and heart rate, were significantly less pronounced in the UBS group (P < 0.05) than in the conventional instrumentation group. Serum epinephrine (E) and norepinephrine levels significantly reduced (P < 0.05). Postoperative anxiety scores were also lower in the UBS group (P < 0.05) than in the conventional instrumentation group. CONCLUSION: Compared with conventional tools, UBS may offer better control over noise-related acute cardiovascular stress responses. However, mild-to-moderate autonomic and hormonal stress responses persist (e.g., postoperative rMSSD reduction <20% of the baseline and E elevation 500 pg/mL, which is consistent with established thresholds for mild-to-moderate stress), and their interaction with anxiety requires further exploration.