Findings Refute Common Belief of Spinal Superiority
Feb. 4, 2000 (Tuscaloosa, Ala.) -- More than 250,000 people in the United States over age 65 will fracture a hip during the coming year, and medical care for that injury will cost an estimated $5 billion yearly, according to the National Center for Health Statistics. But for anyone unfortunate enough to have to undergo surgery to repair a broken hip, there is a bit of good news: According to a recent study, general anesthesia is as safe and effective as spinal anesthesia.
"General anesthesia was at least as efficacious as spinal anesthesia, and possibly better, in affording good long-term outcome," Timothy Gilbert, MD, tells WebMD.
Gilbert, chief of cardiothoracic anesthesiology and an associate professor of anesthesiology at the University of Maryland School of Medicine, in Baltimore, is leader of the study that for two years looked at how well elderly patients did following hip fracture repair. Of the 741 patients in the study, 430 received spinal anesthesia and 311 general anesthesia.
"Medical studies show that one out of three older patients with hip fractures die within one year of their injury," Gilbert says. "Twenty-five to 75% of the patients who survive experience reduced mobility and lose the ability to live independent lives. We wanted to see if the choice of anesthesia technique affects those outcomes."
"What some doctors have said to their patients in the past is: 'If you get a spinal, you will do at least as good, if not better than if you get general anesthesia,'" explains Gilbert. "This is the first real evidence that supports the counterargument. What we are saying is that if you get general anesthesia, you will do at least as good, if not better than if you get a spinal."
"Our statistical analysis showed small but statistically significant differences favoring general anesthesia when we looked at the outcome indicators involving social interaction and the ability to walk at least 10 feet unassisted," Gilbert says.
However, the statistical analysis also showed, Gilbert points out, that slightly more patients who received spinal anesthesia reported less pain 12 months after the operation than those who had received general anesthesia. The results of the study were published in the January issue of The American Journal of Orthopedics.