Review
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World J Orthop. Jul 18, 2014; 5(3): 336-343
Published online Jul 18, 2014. doi: 10.5312/wjo.v5.i3.336
Perioperative outcomes and type of anesthesia in hip surgical patients: An evidence based review
Mathias Opperer, Thomas Danninger, Ottokar Stundner, Stavros G Memtsoudis
Mathias Opperer, Ottokar Stundner, Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University, Salzburg 5020, Austria
Thomas Danninger, Stavros G Memtsoudis, Department of Anesthesiology, Hospital for Special Surgery, New York, NY 10021, United States
Author contributions: Opperer M, Danninger T, Stundner O and Memtsoudis SG contributed equally to this work.
Correspondence to: Stavros G Memtsoudis, MD, PhD, FCCP, Department of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 East 70th Street, New York, NY 10021, United States. memtsoudiss@hss.edu
Telephone: +1-212-6061206 Fax: +1-212-5174481
Received: December 26, 2013
Revised: March 25, 2014
Accepted: April 25, 2014
Published online: July 18, 2014
Abstract

Over the last decades the demand for hip surgery, be it elective or in a traumatic setting, has greatly increased and is projected to expand even further. Concurrent with demographic changes the affected population is burdened by an increase in average comorbidity and serious complications. It has been suggested that the choice of anesthesia not only affects the surgery setting but also the perioperative outcome as a whole. Therefore different approaches and anesthetic techniques have been developed to offer individual anesthetic and analgesic care to hip surgery patients. Recent studies on comparative effectiveness utilizing population based data have given us a novel insight on anesthetic practice and outcome, showing favorable results in the usage of regional vs general anesthesia. In this review we aim to give an overview of anesthetic techniques in use for hip surgery and their impact on perioperative outcome. While there still remains a scarcity of data investigating perioperative outcomes and anesthesia, most studies concur on a positive outcome in overall mortality, thromboembolic events, blood loss and transfusion requirements when comparing regional to general anesthesia. Much of the currently available evidence suggests that a comprehensive medical approach with emphasis on regional anesthesia can prove beneficial to patients and the health care system.

Keywords: Perioperative outcome, Regional anesthesia, Neuraxial anesthesia, Hip arthroplasty, Hip fracture

Core tip: Recent studies on comparative effectiveness utilizing population based data have given us a novel insight on anesthetic practice and outcome, showing favorable results in the usage of regional vs. general anesthesia. In this review we aim to give an overview of anesthetic techniques in use for hip surgery and their impact on perioperative outcome. While there still remains a scarcity of data investigating perioperative outcomes and anesthesia, most studies concur on a positive outcome in overall mortality, thromboembolic events, blood loss and transfusion requirements when comparing regional to general anesthesia.