Comparative analysis of general and regional anesthesia applications in geriatric hip fracture surgery

Medicine (Baltimore). 2025 Jan 10;104(2):e41125. doi: 10.1097/MD.0000000000041125.

Abstract

Background: This study compares the outcomes of general anesthesia (GA) and regional anesthesia (RA) in geriatric hip fracture surgery to determine optimal anesthesia strategies for this population.

Methods: A comprehensive literature review was conducted, analyzing studies comparing GA and RA in elderly patients undergoing hip fracture surgery. Studies encompassed various designs, including randomized controlled trials, cohort studies, and meta-analyses. Key analytical techniques included comparative analysis of intraoperative complications, postoperative outcomes, mortality rates, and physiological impacts.

Results: GA was associated with higher risks of intraoperative cardiovascular events, respiratory depression, and postoperative complications such as cognitive dysfunction and delirium. In contrast, RA demonstrated superior outcomes in pain management, early mobilization, and reduced incidences of complications like postoperative nausea and vomiting. RA also correlated with shorter hospital stays and lower mortality rates within the first 30 days post-surgery.

Conclusion: RA emerges as a preferable choice for geriatric hip fracture surgery, offering improved safety profiles, enhanced recovery trajectories, and better postoperative cognitive outcomes compared to GA. These findings underscore the importance of anesthesia selection in optimizing surgical outcomes and patient safety in elderly populations. Future research should focus on prospective trials to validate these results and refine anesthesia protocols tailored to elderly hip fracture patients.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anesthesia, Conduction* / methods
  • Anesthesia, General* / adverse effects
  • Anesthesia, General* / methods
  • Hip Fractures* / surgery
  • Humans
  • Intraoperative Complications / epidemiology
  • Postoperative Complications* / epidemiology