Comparison of General Anesthesia With Endotracheal Intubation, Combined Spinal-epidural Anesthesia, and General Anesthesia With Laryngeal Mask Airway and Nerve Block for Intertrochanteric Fracture Surgeries in Elderly Patients

A Retrospective Cohort Study

Yang Liu; Mang Su; Wei Li; Hao Yuan; Cheng Yang


BMC Anesthesiol. 2019;19(230) 

In This Article


The global population aging has led to increasingly more elderly patients with hip fractures. Aging is associated with decreased hemodynamic stability, hypertension, poor physical status, risk of cognitive impairment, and osteoporosis.[1–3] Providing anesthesia for hip fracture surgeries in elderly patients can be challenging.

It has been shown that regional anesthesia is comparable to general anesthesia for hip fractures in adults.[4] However, it is not known whether regional anesthesia is superior to general anesthesia in terms of hemodynamic stability and postoperative cognitive impairment in elderly patients undergoing hip surgeries. A previous study found that general anesthesia with endotracheal intubation was associated with intraoperative hypotension and hemodynamic instability in elderly patients undergoing hip surgeries compared to general anesthesia with laryngeal mask airway (LMA) and nerve block.[5] The effect of these two anesthetic methods on postoperative cognitive function in elderly patients is still not clear.

Our study aimed to compare intraoperative hemodynamics, postoperative pain, postoperative cognitive function, and respiratory infection between general anesthesia with endotracheal intubation, combined spinal-epidural anesthesia, and general anesthesia with LMA and nerve block for elderly patients undergoing intertrochanteric fracture surgeries.