Key result
Spinal anesthesia shows equivalent safety and acceptability to general anesthesia for older adults undergoing surgery.
Why the study?
Comparing outcomes of spinal versus general anesthesia in older adults is an important focus of comparative effectiveness research to help guide patient and clinician treatment decisions.
Does spinal anesthesia improve safety and acceptability compared to general anesthesia in older adults undergoing surgery?
Does spinal anesthesia improve safety and acceptability compared to general anesthesia in older adults undergoing surgery?
Spinal and general anesthesia are equivalent in safety and acceptability for older adults undergoing surgery, suggesting the choice should be guided by patient preference.
Supports individualized anesthesia choice by patient factors in older adults; confirms equivalence in a large RCT.
Comparative effectiveness research aims to understand the benefits and harms of different treatments to assist patients and clinicians in making better decisions. Within anesthesia practice, comparing outcomes of spinal versus general anesthesia in older adults represents an important focus of comparative effectiveness research. The authors review methodologic issues involved in studying this topic and summarize available evidence from randomized studies in patients undergoing hip fracture surgery, elective knee and hip arthroplasty, and vascular surgery. Across contexts, randomized trials show that spinal and general anesthesia are likely to be equivalent in terms of safety and acceptability for most patients without contraindications. Choices between spinal and general anesthesia represent "preference-sensitive" care in which decisions should be guided by patients' preferences and values, informed by best available evidence.
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Neuman et al. (2023) conducted a review in Surgery in older adults. Spinal anesthesia vs. General anesthesia was evaluated on Safety and acceptability. Spinal and general anesthesia are likely to be equivalent in terms of safety and acceptability for most older adults without contraindications undergoing surgery.
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