According to major research, spinal anesthesia is not more safe or effective than general anesthesia for patients who have hip fracture surgery. This finding challenges the commonly held view and gives doctors and patients more information to help them choose the best method for them. Based on the published literature, the assumption among the anesthesia and surgical community was that spinal anesthesia was the safest option. Derek Dillane, coauthor, acting chair of anesthesia and pain medicine, University of Alberta's Faculty of Medicine & Dentistry. These assumptions are being reevaluated as they are based upon smaller retrospective studies that look back at patient records after surgery.
His colleagues and he conducted a prospective study. This is generally the most reliable type of research. They enrolled new patients and randomly assigned them to spinal or general anesthesia. Then they monitored their results. This is the largest clinical trial on the subject, with 1,600 patients over 50 at 46 American and Canadian hospitals. The New England Journal of Medicine published the results. The primary outcomes of the surgery were death or inability to walk independently for three meters at two months. There was no difference in the results between the two types. Both groups had similar rates of post-operative depression and hospital stays. There were slightly lower risks of spinal anesthesia being used for death during hospitalizations, pneumonia or admission to intensive care Office based anesthesia.
Spinal anesthesia can make it difficult for patients with hip fractures to move onto their side for spinal anesthesia. There is also a chance of spinal bleeding in patients who are on blood thinners. General anesthesia may cause dementia. He explained that the method chosen is always tailored to each patient's needs and medical history.
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