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Open Access Journal Article

Neuraxial anesthesia compared to general anesthesia in subjects with hip fracture surgery: A meta-analysis

by Hasnaa Osama 1 ,  Haitham Saeed 1 ,  Mina Nicola 1  and  Marina Emad 1,*
1
Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
*
Author to whom correspondence should be addressed.
IJCMR  2023, 9; 1(2), 9; https://doi.org/10.61466/ijcmr1020009
Received: 22 August 2023 / Accepted: 26 September 2023 / Published Online: 28 September 2023
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Abstract

Background

We performed a meta-analysis to evaluate the effects of neuraxial anesthesia compared to general anesthesia on postoperative results in hip fracture surgery subjects.

Methods

A systematic literature search up to January 2021 was done and 20 studies included 298785 subjects with hip fracture surgery at the start of the study; 80783 of them were under neuraxial anesthesia, and 218002 of them were under general anesthesia. They were reporting relationships between the effects of neuraxial anesthesia compared to general anesthesia in subjects with hip fracture surgery. We calculated the odds ratio (OR) or the mean difference (MD) with 95% confidence intervals (CIs) to assess the effects of neuraxial anesthesia compared to general anesthesia in subjects with hip fracture surgery using the dichotomous or continuous method with a random or fixed-effect model.

Results

Neuraxial anesthesia in subjects with hip fracture surgery was significantly related to lower acute myocardial infarction (OR, 0.73; 95% CI, 0.54-0.99, p=0.04), hypotension (OR, 0.37; 95% CI, 0.20-0.70, p=0.002), and postoperative cognitive dysfunction postoperative 1day (OR, 0.27; 95% CI, 0.17-0.42, p<0.001) compared to general anesthesia.

However, no significant difference was found between neuraxial anesthesia and general anesthesia in subjects with hip fracture surgery in a postoperative cognitive dysfunction postoperative 7days (OR, 0.64; 95% CI, 0.37-1.09, p=0.10), pneumonia (OR, 0.69; 95% CI, 0.29-1.62, p=0.39), length of hospital stay (MD, 0.75; 95% CI, -1.39-2.90, p=0.49),  deep venous thrombosis (OR, 1.21; 95% CI, 0.50-2.95, p=0.68), 30-day mortality (OR, 1.12; 95% CI, 0.53-2.34, p=0.77), blood loss (MD, -57.47; 95% CI, -123.36-8.41, p=0.09), and delirium (OR, 0.98; 95% CI, 0.32-2.49, p=0.96).

Conclusions

Neuraxial anesthesia in subjects with hip fracture surgery may decrease the risk of acute myocardial infarction, hypotension, and postoperative cognitive dysfunction postoperative 1 day compared to general anesthesia. Furthers studies are required to validate these findings.

Keywords: hip fracture surgery; neuraxial anesthesia; general anesthesia; epidural anesthesia; spinal anesthesia; postoperative results;
Copyright: © 2023 by Osama, Saeed, Nicola and Emad. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (Creative Commons Attribution 4.0 International License). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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ACS Style
Osama, H.; Saeed, H.; Nicola, M.; Emad, M. Neuraxial anesthesia compared to general anesthesia in subjects with hip fracture surgery: A meta-analysis. International Journal of Clinical Medical Research, 2023, 1, 9. https://doi.org/10.61466/ijcmr1020009
AMA Style
Osama H, Saeed H, Nicola M, Emad M. Neuraxial anesthesia compared to general anesthesia in subjects with hip fracture surgery: A meta-analysis. International Journal of Clinical Medical Research; 2023, 1(2):9. https://doi.org/10.61466/ijcmr1020009
Chicago/Turabian Style
Osama, Hasnaa; Saeed, Haitham; Nicola, Mina; Emad, Marina 2023. "Neuraxial anesthesia compared to general anesthesia in subjects with hip fracture surgery: A meta-analysis" International Journal of Clinical Medical Research 1, no.2:9. https://doi.org/10.61466/ijcmr1020009

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