Background and Aims Hip fractures are some of the most frequent types of injuries among geriatric patients and they are mostly being managed surgically. Despite the development of different anesthesia techniques, this orthopedic procedure is still associated with increased morbidity and mortality rates. While General Anesthesia might be the preferred technique for patients on anticoagulants, Regional Anesthesia could be an alternative for elders for whom avoidance of airway instrumentation and reduced cardiopulmonary stress is mandatory. Recent medical literature has shown conflicting results regarding postoperative outcomes in geriatric hip fracture patients with different anesthesia techniques. The aim of this presentations is to illustrate the mechanisms of regional anesthesia and to assess its effectiveness when compared to general anesthesia for this patient category.
Methods This review describes the advantages and disadvantages of both anesthetic techniques, as encountered in the recent medical literature.
Results The recent studies describing comparative efficacy of RA and GA showed no significant difference for 30 days mortality or length of stay. Also, there was no significant difference between the prevalence of postoperative delirium at 24h, 3 days and 7 days. Patients receiving spinal anesthesia required more analgesic prescriptions at 60 days compared to the GA group.
Conclusions Although certain categories of geriatric hip fracture patients could certainly benefit from the usage of regional anesthesia, recent studies demonstrated no significant difference in postoperative outcomes. While definitive studies with larger sample size and adherence to a medical protocol are still in progress, the recommendations remain to adapt the anesthesia technique to the needs of the patient.
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