Among more than 56,000 adults undergoing hip repair between 2004 and 2011, the use of regional anaesthesia compared with general anaesthesia was not associated with a lower risk of death at 30 days, but was associated with a modestly shorter length of hospital stay, according to a study published in the June 25 issue of JAMA.
Regional anaesthesia for hip fracture surgery may reduce postoperative complications, and practice guidelines have called for broader use of regional anaesthesia for hip fracture surgery, according to Mark D. Neuman, MD, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, and colleagues.
The researchers assessed the association of regional anaesthesia versus general anaesthesia with 30-day mortality and hospital length of stay after hip fracture surgery. The study included patients aged 50 years or older who were undergoing surgery for hip fracture at general acute care hospitals in New York State between July 2004 and December 2011.
Of 56,729 patients, 15,904 (28%) received regional anaesthesia and 40,825 (72 percent) received general anaesthesia.
Overall, 3,032 patients (5.3%) died within 30 days of surgery. The researchers did not observe a statistically significant difference in mortality according to anaesthesia technique. They did find that regional anaesthesia was associated with approximately a half day shorter length of hospital stay.
“Our findings may have implications for clinical practice and health policy,” the authors wrote. “Regional anaesthesia is used as the primary aesthetic technique in a minority of hip fracture surgeries performed in the United States and in other countries, and increasing its use has been proposed as a strategy to improve the quality of hip fracture care. We found an association between greater use of regional anaesthesia and a reduction in length of stay after hip fracture; however, we did not find regional anaesthesia to be associated with statistically significant differences in mortality. These findings do not support a mortality benefit for regional anaesthesia in this setting.”