There is (probably) no (meaningful) difference in (most) outcomes between 'spinal' and 'general' anaesthesia for hip fracture surgery: time to move forward
- PMID: 36801101
- DOI: 10.1016/j.bja.2023.01.013
There is (probably) no (meaningful) difference in (most) outcomes between 'spinal' and 'general' anaesthesia for hip fracture surgery: time to move forward
Abstract
A meta-analysis influenced by two recent large randomised controlled trials (REGAIN and RAGA) concluded that little, if any, difference in commonly measured outcomes exists between patients administered spinal or general anaesthesia for their hip fracture surgery. We explore whether there is genuinely no difference, or what the methodological problems in research might be that prevent any real difference from being observed. We also discuss the need for greater nuance in future research to determine how anaesthetists might deliver perioperative care towards improving postoperative recovery trajectories in patients following hip fracture.
Keywords: general anaesthesia; geriatric anaesthesia; hip fracture; postoperative outcomes; spinal anaesthesia.
Copyright © 2023 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.
Comment on
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Clinical effectiveness and safety of spinal anaesthesia compared with general anaesthesia in patients undergoing hip fracture surgery using a consensus-based core outcome set and patient-and public-informed outcomes: a systematic review and meta-analysis of randomised controlled trials.Br J Anaesth. 2022 Nov;129(5):788-800. doi: 10.1016/j.bja.2022.07.031. Epub 2022 Sep 28. Br J Anaesth. 2022. PMID: 36270701 Free PMC article.
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