• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • 2MM Podcast
  • Write for us
  • Contact Us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan+
  • Wellness
  • Classicsâ„¢+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Career
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan+
  • Wellness
  • Classicsâ„¢+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Career
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Emergency

Spinal anesthesia not superior to general anesthesia for hip surgery

byNhat Hung (Benjamin) LamandHarsh Shah
January 10, 2022
in Emergency, Orthopedic Surgery, Surgery
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. Spinal anesthesia was not superior to general anesthesia for hip surgery in older adults in survival and ambulatory status at 60 days.

2. Postoperative delirium rate was similar between the spinal and general anesthesia groups.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Surgery is the standard of care for hip fractures, using either spinal or general anesthesia. While some observational evidence suggested that spinal anesthesia might offer better recovery and fewer complications, randomized trials are inconclusive and outdated from current practice. Especially, there is a lack of trials investigating the recovery of walking ability after the procedure, an important outcome for patients. The current study aimed to evaluate the recovery of ambulation of older adults following hip surgery utilizing spinal anesthesia, compared to general anesthesia. The primary outcome was a composite of death or an inability to walk 10ft independently at 60 days after randomization, it was shown that the primary outcome was comparable between the two patient groups. Similarly, the rates of death and delirium at 60 days and hospital length of stay were not different between the two anesthesia regimens. Notable limitations include missing outcome data and heterogeneity in sedation techniques. Nonetheless, the trial showed that in older patients undergoing hip surgery, spinal anesthesia was not superior to general anesthesia in risk of death or inability to walk independently at 60 days.

Click here to read the study in NEJM

Relevant Reading: General versus regional anaesthesia for hip fractures. A pilot randomised controlled trial of 322 patients

RELATED REPORTS

#VisualAbstract: ACTFAST-3 intraoperative telemedicine program not associated with improved perioperative outcomes

ACTFAST-3 intraoperative telemedicine program not associated with improved perioperative outcomes

Physical and psychological recovery after vaginal childbirth with and without epidural analgesia

In-Depth [randomized controlled trial]: This pragmatic randomized trial enrolled 1600 patients 50 years of age or older who were undergoing surgical repair of hip fractures at 46 U.S. and Canadian centers. Patients were included based on age and diagnosis of femoral neck, intertrochanteric or subtrochanteric hip fracture. Patients were excluded if they had not been able to walk 10ft independently prior to the fracture, if the fracture was periprosthetic, if they were at risk of malignant hyperthermia, or if spinal anesthesia was contraindicated. Patients were randomized 1:1 to receive spinal anesthesia (by a single-injection spinal anesthetic coupled with appropriate sedation) or general anesthesia (with an inhaled maintenance anesthetic). Crossover between the anesthetic regiments occurred in 15% of patients assigned to spinal anesthesia and 3.5% of those assigned to general anesthesia. Modified intention-to-treat analysis included 1599 patients. The primary outcome was a composite of death and an inability to walk 10ft independently at 60 days after randomization. Secondary outcomes included the rates of death, new inability to walk at 60 days in alive patients, new-onset delirium, and length of hospital stay. The mean age of the patient population was 78% and 67.0% were women. In the modified intention-to-treat population, the composite primary outcome occurred in 18.5% patients undergoing spinal anesthesia and 18.0% in those undergoing general anesthesia (relative risk [RR], 1.03; 95% confidence interval [CI], 0.84 to 1.27; P=0.83). Within this composite outcome, death occurred in 3.9% of patients in the spinal anesthesia group and 4.1% in the general anesthesia group (RR, 0.97; 95% CI, 0.59 to 1.57), while an inability to walk independently was reported in 15.2% and 14.4%, respectively (RR, 1.06; 95% CI, 0.82 to 1.36). Furthermore, new-onset delirium occurred in 20.5% of patients in the spinal anesthesia group and 19.7% in the general anesthesia group (RR, 1.04; 95% CI, 0.84 to 1.30). The median length of hospital stay was identical between the two groups: 6 days for Canadian centers (hazard ratio [HR], 0.92; 95% CI, 0.76 to 1.10) and 3 days for U.S. centers (HR, 1.06; 95% CI, 0.96 to 1.16). The incidence of other adverse events was similar between the two regimens. The trial was significant in its focus on the recovery of the ability to walk as a primary outcome following hip fracture surgery, as well as examining outcomes beyond hospital discharge. Despite limitations regarding missing data and variability of sedation protocol during spinal anesthesia, the study showed that spinal anesthesia was not superior to general anesthesia for hip fracture surgery in older adults.

Image: PD

©2022 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: anesthesiahip arthroplastyhip fractureregional anesthesiaspinal anesthesia
Previous Post

Bastilimab plus zalifrelimab showed promising clinical and safety response for the treatment of refractory cervical cancer

Next Post

Accuracy of glomerular filtration rate estimation with use of Cystatin C

RelatedReports

#VisualAbstract: ACTFAST-3 intraoperative telemedicine program not associated with improved perioperative outcomes
StudyGraphics

#VisualAbstract: ACTFAST-3 intraoperative telemedicine program not associated with improved perioperative outcomes

November 28, 2023
General anesthesia exposure in infants not linked to impaired cognitive development
Orthopedic Surgery

ACTFAST-3 intraoperative telemedicine program not associated with improved perioperative outcomes

November 16, 2023
Increased risk of stillbirth recurrence after a previous stillbirth
Obstetrics

Physical and psychological recovery after vaginal childbirth with and without epidural analgesia

October 12, 2023
Postextubation administration of high-flow oxygen leads to reduced reintubation and respiratory failure
Emergency

Video laryngoscopy leads to higher success on first intubation attempt than direct laryngoscopy

September 13, 2023
Next Post
Solitary kidney not associated with contrast-induced nephropathy

Accuracy of glomerular filtration rate estimation with use of Cystatin C

#VisualAbstract: Acral lentiginous melanoma may be associated with higher rates of sentinel lymph node positivity compared to other melanoma subtypes

#VisualAbstract: Acral lentiginous melanoma may be associated with higher rates of sentinel lymph node positivity compared to other melanoma subtypes

Decreased expression of nasal ACE2 may be correlated with lower prevalence of COVID-19 in children

In utero exposure to maternal SARS-CoV-2 infection not associated with neurodevelopmental deficits at 6 months

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Seriesâ„¢ textbook.

Subscription Options

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • A Begginer’s Guide to Understanding Odds Ratios, Confidence Intervals, and P-values
  • #VisualAbstract: Intravenous Levothyroxine Does Not Increase the Number of Heart Transplants in Unstable Brain-Dead Potential Heart Donors
  • #VisualAbstract: Dapagliflozin does not reduce albuminuria in patients with heart failure and type 2 diabetes (DAPPER study)
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classicsâ„¢
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Career
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
No Result
View All Result

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options