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Purpose of Review <p>Continuous controversy exists in the potential association of regional anesthesia or general anesthesia with clinical outcomes in geriatric surgeries.</p> Recent Findings <p>The publication of several high-quality randomized control trials in hip fracture repair have provided evidence that neither intraoperative spinal nor general anesthesia is superior in most elderly with regard to major outcomes including pain and delirium. However, some previously reported outcome differences in retrospective studies, such as blood loss, persist in recent large observational cohorts. Therefore, it remains unclear if certain subpopulations, such as the oldest-old (85 +) or those with higher ASA status, may benefit from a specific anesthetic modality.</p> Summary <p>In the current trend of multimodal analgesia and early recovery after surgery, particularly with the increasing adoption of peripheral nerve blocks, the outcome differences between spinal anesthesia and general anesthesia in elderly patients undergoing orthopedic surgeries appear to be of diminished clinical significance.</p>

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Regional Versus General Anesthesia in the Elderly: A Nuanced Approach

  • 期刊论文

  • 发表日期：

    2025年8月1日

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  • Lanya Tseng,
  • Bartlomiej Bartkowiak,
  • Haoning Lan,
  • Nada Pejcic,
  • Sergio Munoz-Correa,
  • Andrew Mullin,
  • Yabtsega Moges,
  • Alexandria Brackett,
  • Jinlei Li

摘要

Purpose of Review

Continuous controversy exists in the potential association of regional anesthesia or general anesthesia with clinical outcomes in geriatric surgeries.

Recent Findings

The publication of several high-quality randomized control trials in hip fracture repair have provided evidence that neither intraoperative spinal nor general anesthesia is superior in most elderly with regard to major outcomes including pain and delirium. However, some previously reported outcome differences in retrospective studies, such as blood loss, persist in recent large observational cohorts. Therefore, it remains unclear if certain subpopulations, such as the oldest-old (85 +) or those with higher ASA status, may benefit from a specific anesthetic modality.

Summary

In the current trend of multimodal analgesia and early recovery after surgery, particularly with the increasing adoption of peripheral nerve blocks, the outcome differences between spinal anesthesia and general anesthesia in elderly patients undergoing orthopedic surgeries appear to be of diminished clinical significance.