Comparing perioperative complications and recovery outcomes of neuraxial versus general anesthesia in hip fracture surgery: A systematic review and meta-analysis.
- 1Department of Surgical and Interventional Sciences, McGill University, Montreal, Québec, Canada.
- 2Department of Anaesthesia, McGill University, Montreal, Québec, Canada.
- 3Department of Surgery, McGill University, Montreal, Québec, Canada.
Abstract
To compare perioperative complications and recovery outcomes between neuraxial and general anesthesia in adult patients undergoing hip fracture surgery. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted following PRISMA guidelines. MEDLINE, Embase, CENTRAL, and Scopus were searched from 2000 to April 25, 2026. Studies comparing neuraxial and general anesthesia were included. Outcomes included mortality (in-hospital, 30-day, 90-day, 1-year), intraoperative hypotension, postoperative delirium, acute coronary syndrome (ACS), pneumonia, acute kidney injury (AKI), length of hospital stay, and postoperative nausea and vomiting (PONV). Random-effects models were used to calculate pooled effect estimates. Nineteen RCTs (n = 4,742) were included. No significant differences were observed between neuraxial and general anesthesia for mortality at any time point, postoperative delirium, ACS, pneumonia, or PONV. Neuraxial anesthesia was associated with a lower risk of intraoperative hypotension (RR 0.55, 95% CI 0.40-0.77) and AKI (RR 0.57, 95% CI 0.38-0.84), and shorter length of hospital stay (MD - 0.58 days, 95% CI - 1.08 to - 0.07). Heterogeneity was substantial for some outcomes. Neuraxial anesthesia decreases the risk of intraoperative hypertension and acute kidney injury in comparison to general anesthesia in patients undergoing hip fracture repair.
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BibTeX
@article{low2026comparing,
title = {{Comparing perioperative complications and recovery outcomes of neuraxial versus general anesthesia in hip fracture surgery: A systematic review and meta-analysis.}},
author = {Angelina Low and Sean Jeffries and Avinash Sinha and Oliver Cafferty and Eric Pelletier and Robert Harutyunyan and Thomas M Hemmerling},
journal = {Saudi journal of anaesthesia},
year = {2026},
month = oct,
doi = {10.4103/sja.sja_570_26},
url = {https://europepmc.org/article/MED/42960016},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Comparing perioperative complications and recovery outcomes of neuraxial versus general anesthesia in hip fracture surgery: A systematic review and meta-analysis.
AU - Angelina Low
AU - Sean Jeffries
AU - Avinash Sinha
AU - Oliver Cafferty
AU - Eric Pelletier
AU - Robert Harutyunyan
AU - Thomas M Hemmerling
PY - 2026
DA - 2026/10/01
JO - Saudi journal of anaesthesia
DO - 10.4103/sja.sja_570_26
UR - https://europepmc.org/article/MED/42960016
AB - To compare perioperative complications and recovery outcomes between neuraxial and general anesthesia in adult patients undergoing hip fracture surgery. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted following PRISMA guidelines. MEDLINE, Embase, CENTRAL, and Scopus were searched from 2000 to April 25, 2026. Studies comparing neuraxial and general anesthesia were included. Outcomes included mortality (in-hospital, 30-day, 90-day, 1-year), intraoperative hypotension, postoperative delirium, acute coronary syndrome (ACS), pneumonia, acute kidney injury (AKI), length of hospital stay, and postoperative nausea and vomiting (PONV). Random-effects models were used to calculate pooled effect estimates. Nineteen RCTs (n = 4,742) were included. No significant differences were observed between neuraxial and general anesthesia for mortality at any time point, postoperative delirium, ACS, pneumonia, or PONV. Neuraxial anesthesia was associated with a lower risk of intraoperative hypotension (RR 0.55, 95% CI 0.40-0.77) and AKI (RR 0.57, 95% CI 0.38-0.84), and shorter length of hospital stay (MD - 0.58 days, 95% CI - 1.08 to - 0.07). Heterogeneity was substantial for some outcomes. Neuraxial anesthesia decreases the risk of intraoperative hypertension and acute kidney injury in comparison to general anesthesia in patients undergoing hip fracture repair.
SN - 1658-354X
SN - 0975-3125
ER -