Anaesthesia for hip fracture surgery in adults

Parker, Martyn J.; S, Unwin; Handoll, Helen; Griffiths, R.

doi:10.1002/14651858.cd000521

Cited by 133 publications

(143 citation statements)

References 36 publications

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“…2,[4][5][6]8 We demonstrated the same result as in these previous studies, but the length of follow-up among our included studies reached six months in only one study and was less than three months in the others.…”

Section: Knee Surgerysupporting

confidence: 86%

“…45 Parker et al analyzed patients who underwent hip fracture surgery and found that the rate of myocardial infarction was 1% (5/505) in the neuraxial anesthesia group. 8 Our rate for this outcome was 1.7% (5/291) with no statistically significant difference, but those authors analyzed thoracic epidural anesthesia.…”

Section: Knee Surgerymentioning

confidence: 69%

“…Thus, controversy remains regarding the effectiveness and safety of neuraxial anesthesia. 2,[5][6][7][8] In this context, we proposed to answer the research question: what is the effectiveness and safety of neuraxial anesthesia, in comparison with general anesthesia for orthopedic surgery?…”

Section: Introductionmentioning

confidence: 99%

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Neuraxial anesthesia for orthopedic surgery: systematic review and meta-analysis of randomized clinical trials

2013

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CONTEXT AND OBJECTIVE: Taking the outcome of mortality into consideration, there is controversy about the beneficial effects of neuraxial anesthesia for orthopedic surgery. SciELO, EMBASE (1974 to November 2012 and reference lists of the studies included. Only randomized controlled trials were included. RESULTS: Out of 5,032 titles and abstracts, 17 studies were included. There were no statistically significant differences in mortality (risk difference, RD: -0.01; 95% confidence interval, CI: -0.04 to 0.01; n = 1903), stroke (RD: 0.02; 95% CI: -0.04 to 0.08; n = 259), myocardial infarction (RD: -0.01; 95% CI: -0.04 to 0.02; n = 291), length of hospitalization (mean difference, -0.05; 95% CI: -0.69 to 0.58; n = 870), postoperative cognitive dysfunction (RD: 0.00; 95% CI: -0.04 to 0.05; n = 479) or pneumonia (odds ratio, 0.61; 95% CI: 0.25 to 1.49; n = 167). CONCLUSION: So far, the evidence available from the studies included is insufficient to prove that neuraxial anesthesia is more effective and safer than general anesthesia for orthopedic surgery. However, this systematic review does not rule out clinically important differences with regard to mortality, stroke, myocardial infarction, length of hospitalization, postoperative cognitive dysfunction or pneumonia. CONCLUSÃO: Até o momento, as evidências são insuficientes nos estudos incluídos para provar que AN é mais efetiva e segura do que AG para cirurgias ortopédicas. Esta revisão sistemática não descartou diferenças clínicas importantes para mortalidade, acidente vascular encefálico, infarto miocárdico, tempo de internação, disfunção cognitiva pós-operatória e pneumonia. RESUMO IMSc. Professor,

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Section: Knee Surgerysupporting

confidence: 86%

Section: Knee Surgerymentioning

confidence: 69%

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Neuraxial anesthesia for orthopedic surgery: systematic review and meta-analysis of randomized clinical trials

2013

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“…Meta-analyses suggest that regional anaesthesia, specifically central neuraxial anesthesia, decreases the incidence of deep venous thrombosis (DVT) and pulmonary embolism as well as the incidence of postoperative confusion, in addition to reducing the risk of postoperative pneumonia in patients who require surgical stabilization [24,25].…”

Section: Discussionmentioning

confidence: 99%

Effect of Different Doses of Dexmedetomidine as Adjuvant in Bupivacaine -Induced Subarachnoid Block for Traumatized Lower Limb Orthopaedic Surgery: A Prospective, Double-Blinded and Randomized Controlled Study

Halder

Das

Mandal

et al. 2014

JCDR

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“…Although NA may reduce the number of postoperative complications and improve short-term mortality in patients undergoing TJR, it remains unknown whether it may also influence long-term survival in these patients. 11,12 The primary aim of this study was to evaluate the effect of anesthetic management on long-term survival rate for patients undergoing TJR. The short-term survival rate, length of stay (LOS), and hospital treatment costs were also evaluated.…”

Section: Résumémentioning

confidence: 99%

Neuraxial anesthesia improves long-term survival after total joint replacement: a retrospective nationwide population-based study in Taiwan

Chen

Hung

Tan

et al. 2015

Can J Anesth/J Can Anesth

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Introduction This study explored the effects of general (GA) and neuraxial (NA) anesthesia on the outcomes of primary total joint replacement (TJR) in terms of postoperative mortality, length of stay (LOS), and hospital treatment costs. Methods From 1997 to 2010, this nationwide population-based study retrospectively evaluated 7,977 patients in Taiwan who underwent primary total hip or knee replacement. We generated two propensity-scorematched subgroups, each containing an equal number of patients who underwent TJR with either GA or NA. Results Of the 7,977 patients, 2,990 (37.5%) underwent GA and 4,987 (62.5%) underwent NA. Propensity-score matching was used to create comparable GA and NA groups adjusted for age, sex, comorbidities, surgery type, hospital volume, and surgeon volume. Survival over the first three years following surgery was similar. The proportion of patients alive up to 14 years postoperatively for those undergoing NA was 58.2% (95% confidence interval [CI] 50.4 to 66.0), and for those undergoing GA it was 57.3% (95% CI 51.4 to 63.2). Neuraxial anesthesia was associated with lower median [interquartile range; IQR] hospital treatment cost ($4,079 [3,805-4,444] vs $4,113 [3,812-4,568]; P \ 0.001) and shorter median days vs 8 [6-10] days, respectively; P = 0.024). Conclusions Our results support the use of NA for primary TJR. The improvements in hospital costs persist even when anesthesia costs are removed. The mechanism underlying the association between NA and long-term survival is unknown.

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Anaesthesia for hip fracture surgery in adults

Cited by 133 publications

References 36 publications

Neuraxial anesthesia for orthopedic surgery: systematic review and meta-analysis of randomized clinical trials

Neuraxial anesthesia for orthopedic surgery: systematic review and meta-analysis of randomized clinical trials

Effect of Different Doses of Dexmedetomidine as Adjuvant in Bupivacaine -Induced Subarachnoid Block for Traumatized Lower Limb Orthopaedic Surgery: A Prospective, Double-Blinded and Randomized Controlled Study

Neuraxial anesthesia improves long-term survival after total joint replacement: a retrospective nationwide population-based study in Taiwan

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