Regional versus general anesthesia in patients underwent hip fracture surgery over 80 years old: A retrospective cohort study

Abstract

Aim: To determine the optimum anesthetic technique, namely general or regional anesthesia, for elderly patients over 80 years old with hip fracture surgery with respect to demographic characteristics, hemodynamics, length of hospital stay, and mortality. Material and Methods: Patients with the American Society of Anesthesiology (ASA) scores of II–IV aged over 80 years old were included in our study. The patients were retrospectively allocated to two cohort study groups: regional anesthesia (Group GA, n=41) and general anesthesia (Group RA, n=19). The demographic characteristics, hemodynamics, length of hospital stay, and mortality were recorded. Results: The two groups were similar with respect to age, sex, height, weight, body mass index, ideal body weight, ASA scores, and smoking. The number of patients using drugs in Group RA was significantly more than Group GA. The need for invasive arterial monitorization, central venous catheter, and nasogastric tube in Group RA were significantly less. The duration of anesthesia and surgery in Group RA were significantly shorter than Group GA. The length of ICU and hospital stays in Group RA were significantly shorter than Group GA. Hospital mortality of Group GA was significantly higher than that in Group RA. Conclusion: The present retrospective cohort study showed that perioperative complications, duration of anesthesia and surgery, admission to the postoperative ICU, length of ICU and hospital stay, and also mortality in regional anesthesia were significantly lower in comparison with general anesthesia. We therefore conclude that regional anesthesia can be used safely with patients during hip fracture surgery.