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In hip fracture surgery, spinal anesthesia was associated with more pain and greater use of analgesics after surgery.
Compared to general anesthesia, spinal anesthesia was linked with more prescription analgesic usage at 60 days and greater pain during the first 24 hrs after surgery, as elucidated from a randomized clinical trial. Mark D. Neuman et al. aimed to compare satisfaction, use of analgesics, and pain following hip fracture surgery with spinal vs. general anesthesia.
Overall, 1600 patients (≥ 50 years of age, 77% women) undergoing hip fracture surgery were recruited and administered either general or spinal anesthesia. Estimation of satisfaction with care, pain on postoperative days 1-3; and 60-, 180-, and 365-day pain and prescription analgesic usage was done. During the initial 24 hrs post-surgery, severe pain was reported by 73.5% (1050 of 1428) patients. With spinal anesthesia, the worst pain over the first 24 hrs following surgery was higher (mean difference 0.40). No difference was witnessed in pain across both groups at other time points.
The utilization of prescription analgesic at 60 days eventuated in 18.8% (108 of 574) and 25% (141 of 563) of patients assigned to general and anesthesia spinal respectively (relative risk 1.33). Satisfaction was comparable across groups. Severe pain is common following a hip fracture. Hence, general anesthesia appears to be better than spinal anesthesia for people scheduled to undergo hip fracture surgery.
Annals of Internal Medicine
Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery, A Randomized Clinical Trial
Mark D. Neuman et al.
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