By: 15 August 2014
Regional anaesthesia cuts length of hospital stay after hip surgery

The use of regional compared with general anaesthesia is associated with a modest reduction in the length of hospital stay according to a study of more than 56,000 adults undergoing hip repair between 2004 and 2011.

Mark Neumann, of the Perelman School of Medicine at the University of Pennsylvania, and colleagues assessed the association of regional anaesthesia (spinal or epidural) versus general anaesthesia with 30-day mortality and hospital length of stay after hip fracture surgery. The study included patients 50 years of age or older who were undergoing surgery for hip fracture at general acute care hospitals.

The team analysed 56,729 patients, of whom 28% received regional anaesthesia and 72% received a general anaesthetic. Overall, 3,032 patients (5.3%) died within 30 days of surgery. The researchers observed no statistically significant difference in mortality according to the anaesthesia technique used. They did find, however, that regional anaesthesia was associated with approximately a half day shorter length of hospital stay.

“Our findings may have implications for clinical practice and health policy,” wrote Neumann. “Regional anaesthesia is used as the primary anaesthetic technique in a minority of hip fracture surgeries performed in the United States and in other countries, and increasing its use has been proposed as a strategy to improve the quality of hip fracture care.”

Neumann, M.D., Rosenbaum, P.R., Ludwig, J.M., et al. (2014) Anesthesia technique, mortality and length of stay after hip fracture surgery. JAMA 311(24), 2508–2517