International Journal For Multidisciplinary Research

E-ISSN: 2582-2160   •   Impact Factor: 9.24

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Volume 8 Issue 5
September-October 2026

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Regional versus general anesthesia in elderly patients undergoing hip fracture surgery: a narrative review of outcomes and evidence

Author(s) Ms. Hephzibah Solomon P, Ms. Preethi P, Mr. Majid Wani, Mr. Aadesh R Desai
Country India
Abstract Hip fracture is one of the most common and consequential injuries of old age, and the choice of anesthetic technique for its surgical repair remains a subject of active clinical and research interest. This narrative review synthesises evidence from randomized controlled trials, large national registries, and systematic reviews/meta-analyses comparing regional (chiefly spinal) anesthesia with general anesthesia in elderly patients undergoing hip fracture surgery. Drawing principally on the pragmatic REGAIN trial (n = 1,600), a 107,028-patient cohort from the National Hip Fracture Database of England, Wales and Northern Ireland, and pooled data from more than twenty comparative studies, the review examines outcomes including 30-day and in-hospital mortality, postoperative delirium, length of hospital stay, early mobilisation, return to original residence, pain, blood loss and cost. The overall pattern is one of clinical equipoise for hard outcomes such as 60-day mortality and the ability to walk independently, alongside modest but consistent secondary benefits with regional anesthesia — shorter hospital stay, lower odds of delirium, better early mobilisation and higher rates of discharge to original residence — set against greater early postoperative pain and demands on patient cooperation and anatomical suitability. The review concludes that neither technique is categorically superior, and that individualised, shared decision-making informed by patient factors, anticoagulation status, cognitive status and institutional expertise should guide anesthetic choice, supported by joint orthogeriatric and anesthetic care pathways.
Keywords hip fracture; regional anesthesia; spinal anesthesia; general anesthesia; elderly; geriatric surgery; postoperative delirium; mortality; narrative review.
Field Medical / Pharmacy
Published In Volume 8, Issue 5, September-October 2026
Published On 2026-10-04
DOI https://doi.org/10.36948/ijfmr.2026.v08i05.87700
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CrossRef DOI prefix of IJFMR is 10.36948/ijfmr

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