Comparison of Neuraxial Anesthesia versus General Anesthesia on Postoperative Delirium in Hip Fracture Surgery Patients: A Meta-Analysis of Random Controlled Trials

Hip fractures are increasingly common in aging societies and are associated with high mortality rates. Surgery is the primary treatment for hip fracture patients, with the most commonly used anesthetic methods being neuraxial anesthesia and general anesthesia. Postoperative delirium (POD) is a frequent complication following hip fracture surgery, contributing to increased societal burden and patient mortality. Whether different anesthetic methods influence the incidence of POD remains unclear. To explore the impact of anesthetic methods on POD, we conducted this meta-analysis. We systematically searched PubMed, Embase, and the Cochrane Library for randomized controlled trials (RCTs) comparing neuraxial anesthesia and general anesthesia in hip fracture patients, assessing the effects on delirium incidence, mortality, pneumonia, pulmonary embolism, and myocardial infarction. Five RCTs involving 3118 participants were included. Our findings indicate no significant differences between neuraxial and general anesthesia in terms of POD (RR=1.11, P=0.29), mortality (RR=1.00, P=0.98), pneumonia (RR=0.61, P=0.12), pulmonary embolism (RR=0.62, P=0.43), or myocardial infarction (RR=0.76, P=0.53). Both neuraxial and general anesthesia are effective options for elderly patients undergoing hip fracture surgery.