New research highlighted at the 2018 43rd Annual Regional Anesthesiology and Acute Pain Medicine Meeting, hosted by the American Society of Regional Anesthesia and Pain Medicine, held in New York City, reveals findings related to the association between the use of spinal anesthesia compared to general anesthesia, with a potentially reduced 90-day mortality in hip-fracture surgery patients.

Sarah Tierney, MD, a regional anesthesia fellow at the University of Toronto, and colleagues examined the potential association between the type of anesthesia used and a 90-day reduced mortality in patients who underwent hip-fracture surgery. This new study explored the use of spinal anesthesia and compared outcomes such as blood loss, length of stay, and embolism to patients who received general anesthesia.

The research team conducted a retrospective analysis of the electronic database used by the hospital to identify 2,591 individuals who had received hip fracture–fixation surgery (883 of whom received spinal anesthesia). Outcomes data were extracted and later statistically analyzed using propensity scores from the matched-pairs cohort. The primary outcome for this analysis was 90-day inpatient mortality with secondary outcomes, including 30- and 60-day mortality as well as major acute cardiac and bleeding events and pulmonary embolism.

Researchers concluded that there was not a significant difference in mortality at either the 30- or 60-day time periods in either of the groups; however, patients who received general anesthesia had a greater mortality at 90 days when compared with individuals who received spinal anesthesia (8.6% vs. 6.3%, respectively; P <0.001).

According to Tierney, previous studies have not shown a strong mortality benefit between the different anesthesia interventions, and in a recent press interview, she highlighted the importance of this current study. “When spinal anesthesia is used over general anesthesia, it’s been shown that significant physiological benefits occur, including greater hemodynamic stability, lower incidence of respiratory events, less cognitive dysfunction in the immediate perioperative period, increased perioperative analgesia and decreased blood loss,” she said.

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