Impact of regional anesthesia vs general anesthesia on postoperative outcomes in elderly patients with hip fracture: a meta-analysis.

The objective of this study was to utilize meta-analysis to com-pare the impact of regional anesthesia (RA) versus general anesthesia (GA) on postoperative outcomes in elderly patients undergoing hip fracture surgery. Electronic databases (PubMed, Web of Science, Cochrane Library, and Embase) were searched for randomized controlled trials (RCTs) comparing the effects of RA and GA in elderly patients undergoing hip fracture surgery. The random or fixed-effects model was used to calculate pooled relative risks (RR) and mean differences (MD). Fourteen RCTs involving 5626 elderly patients undergoing hip fracture surgery were included. Meta-analysis indicated that RA was associ-ated with a lower incidence of intraoperative blood loss (MD: -39.7 mL; 95% CI: -68.61, -10.84; p = 0.007), adverse events including intraoperative hypotension (RR: 1.09; 95% CI: 0.90, 1.32; p = 0.005) and postoperative cognitive dysfunc-tion (RR: 0.56; 95% CI: 0.37, 0.86; p = 0.007) compared to GA. However, no statistically significant differences were found between RA and GA regarding surgical time, anesthesia time, intraoperative transfusion, hospital length, de-lirium, and mortality. RA can effectively reduce intraoperative blood loss and the risk of hypotension. Due to the current lack of evidence, no positive effects of RA on other postoperative outcomes were identified. A rigorously designed, high-quality study is warranted to determine the impact of anesthesia type on elderly hip fracture patients.