Does the type of anaesthesia (general, spinal, or combined) affect complications and mortality in patients undergoing surgery for femoral neck fractures?
In patients undergoing surgery for femoral neck fractures, the choice between general, spinal, or combined anaesthesia does not independently determine the risk of perioperative complications or mortality when accounting for patient factors.
Abstract. An analysis has been made of 166 patients (31 men, 135 vomen, mean age 71.9 years) with fractures of the femoral neck. Of these patients 150 were operated on, using three types of anaesthesia: general, spinal, or combined spinal and general anaesthesia. There was a correlation between increasing age and concurrent diseases (especially cardiac insufficiency, aortic stenosis, hypertension and pulmonary insufficiency), on the one hand, and complications during and after surgery on the other. There was a higher percentage of complications and a greater postoperative mortality in the two spinal anaesthesia groups than in the general anaesthesia group, but when all factors influencing the choice of anaesthesia are taken into account, no type of anaesthesia could be regarded as superior to the others in this series. Of the preoperative examinations, the respiratory peak flow value seemed most closely related to the occurrence of complications and could possibly be used to predict the likelihood of difficulties during the operation. There was a high incidence of postoperative pneumonia, and the importance of close postoperative surveillance and breathing exercises is stressed.
Honkonen et al. (Tue,) studied this question.