General versus regional anaesthesia for hip fracture surgery – impact on mortality and length of stay

Abstract

Hip fractures are considered a public epidemic health problem worldwide [1]. It is an extremely common orthopaedic condition with a projection of increase that could range between 7.3 and 21.3 million cases by 2050 [2]. This kind of fracture is more frequent among elderly people and, despite the improvement in medical instruments, surgical and anaesthetic techniques, it is still associated with high morbidity and mortality [3].Both regional and general anaesthesia are valid options for hip fractures surgery, but which technique offers a better outcome remains controversial [4,5]. The choice of anaesthesia is frequently selected by the personal preference of the anaesthesiologist after assessment of the patient's medical status. In the literature, we found several studies that revealed some benefits in using spinal anaesthesia over general anaesthesia for this kind of surgery. Examples of that are: less cognitive dysfunction and better analgesia in the perioperative period with an opioid-sparing effect; decreased blood loss;

Bone Cement and Its Anesthetic Complications: A Narrative Review

“…In a recent study published in 2022, the authors concluded that spinal and general anesthesia both achieve similar outcomes for patients undergoing hip fracture surgery and they observed no differences in mortality between the two anesthetic groups [ 41 ]. In another recent study, Ana et al [ 42 ] identified 562 patients who had hip fracture surgery, 361 of whom were given general anesthesia and 201 of whom were given regional anesthesia. There was no statistically significant difference in the risk of perioperative and 30-day mortality in the adjusted analysis.…”