Appraisal of Anaesthesia for Hip Fracture Surgery in Geriatric Patients: A Retrospective Observational Study

Background and Aim: Hip fractures in the elderly are a rising global public health problem with high morbidity and mortality. Optimizing quality anesthesia care to improve patient outcomes is essential. We aimed to appraise anesthesia techniques in elderly patients with hip fractures, with the objective of comparing the perioperative course, complications, and outcomes. Methodology: A retrospective observational study was conducted after approval by the ethics committee at a tertiary care public institute. During the 1-year study period, we audited anesthesia techniques for hip fracture surgeries in patients >60 years and compared hemodynamic parameters, complications, and postoperative outcome using Epi Info version 7.2. Results: A total of 126 patients (mean age 78 ± 2.2 years) received combined spinal, epidural (CSE) ( n = 76, 60%), combined lumbosacral plexus block (CLSB) ( n = 40, 32%), or general anesthesia (GA) ( n = 10, 8%). Overall complications occurred in 42 patients (55%) with CSE, 8 (20%) with CLSB, and 3 (30%) with GA ( P = 0.001). Hypotension and acute kidney injury were significantly associated with CSE ( P = 0.001). GA was associated with the highest mortality (30%) compared to CSE (9.2%) and CLSB (5%) ( P = 0.007). Conclusion: In geriatric hip surgery, CSE (60%) was the technique of choice, and CLSB (32%) and GA (8%) were used for specific indications in high-risk patients. Hypotension, acute kidney injury, extended intensive care unit stay, and death were associated with CSE and GA, whereas CLSB demonstrated better hemodynamic stability, a better perioperative course, earlier ambulation, and better outcomes in high-risk elderly patients. Regional anesthesia, maintaining hemodynamic stability, is imperative in elderly hip surgery.