Implications of Spinal Anesthesia for Hip Fracture Repair

    Many orthopaedic surgeons and their anesthesiology colleagues are abandoning general anesthesia in favor of regional anesthesia techniques for their elective joint replacement patients.

    Should that be the case for hip fracture patients as well?

    A retrospective analysis of more than 800 patients who underwent surgery for a hip fracture at Maimonides Medical Center in Brooklyn, New York, suggests the answer may be yes.

    Surgeons and anethesiologists from Maimonides looked at length of hospital stay, postoperative morbidity, and in-hospital mortality for 2 groups of patients: those who had general anesthesia (n=416) and those who had spinal anesthesia (n=421).

    In general, patients who had spinal anesthesia fared better, with a lower rate of postoperative complications (9.0% vs. 14.2% for general anesthesia; P=0.023) and a lower in-hospital mortality rate (2.1% vs. 4.1%, respectively; P=0.17). Length of stay was similar for the groups.

    The investigators found that type of anesthesia was not the only factor in the in-hospital mortality rate: The higher the ASA score, the higher the mortality rate, regardless of anesthesia type.

    Maimonides anesthesiologists Paul Yazhemsky, DO, and Piyush Gupta, MD, presented the results at last year’s annual meeting of the American Society of Anesthesiologists. We asked them to share the findings and their implication.

    Click the image above to hear their comments.

    Producer: Susan Doan-Johnson; Director and Post Production: Mike Bugera