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Anaesthesia for hip fracture surgery in adults

  1. Martyn J Parker1,*,
  2. Helen HG Handoll2,
  3. Richard Griffiths3

Editorial Group: Cochrane Anaesthesia Group

Published Online: 18 OCT 2004

Assessed as up-to-date: 11 JUN 2004

DOI: 10.1002/14651858.CD000521.pub2


How to Cite

Parker MJ, Handoll HHG, Griffiths R. Anaesthesia for hip fracture surgery in adults. Cochrane Database of Systematic Reviews 2004, Issue 4. Art. No.: CD000521. DOI: 10.1002/14651858.CD000521.pub2.

Author Information

  1. 1

    Peterborough and Stamford Hospitals NHS Foundation Trust, Department of Orthopaedics, Peterborough, Cambridgeshire, UK

  2. 2

    Teesside University, Health and Social Care Institute, Middlesbrough, Tees Valley, UK

  3. 3

    Peterborough and Stamford Hospitals NHS Foundation Trust, Department of Anaesthesia, Peterborough, Cambridgeshire, UK

*Martyn J Parker, Department of Orthopaedics, Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough City Hospital, CBU PO Box 211, Bretton Gate, Peterborough, Cambridgeshire, PE3 9GZ, UK. martyn.parker@pbh-tr.nhs.uk.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 18 OCT 2004

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Adams 1990 {published data only}
  • Adams HA, Wolf C, Michaelis G, Hempelmann G. Postoperative course and endocrine stress response of geriatric patients with fractured neck of femur [Postoperativer verlauf und endokrine streb-reaktion geriatrischer patienten mit huftnahen frakturen; prospektiv-randomisierte studie zum vergleich von spinalanasthesin und halothan-intubatinosnarkosen]. Anasthesie, Intensivtherapie, Notfallmedizin 1990;25:263-70. [MEDLINE: 1991023367]
Berggren 1987 {published data only}
  • Berggren D, Gustafson Y, Eriksson B, Bucht G, Hansson L-H, Reiz S, et al. Postoperative confusion after anesthesia in elderly patients with femoral neck fractures. Anesthesia and Analgesia 1987;66:497-504. [MEDLINE: 1987211148]
Biffoli 1998 {published data only}
  • Biffoli F, Piacentino V, Meconcelli G, Guidi F, Dal Poggetto L, Bacci I, et al. The effect of anesthesiologic technique on the mental state of elderly patients submitted for orthopedic surgery of the lower limbs [Influenza della condotta anestesiologica sullo stato mentale di soggetti anziani sottoposti a chirurgia ortopedica dell'arto inferiore]. Minerva Anestesiologica 1998;64(1-2):13-9.
Bigler 1985 {published data only}
Bredahl 1991 {published data only}
  • Bredahl C, Hindsholm KB, Frandsen PC. Changes in body heat during hip fracture surgery: a comparison of spinal analgesia and general anaesthesia. Acta Anaesthesiologica Scandinavica 1991;35:548-52. [MEDLINE: 1991377412]
Brichant 1995 {published data only}
  • Brichant JF, Blom-Peters L, Buffels R, Lamy M. Central neural blockage failed to decrease deep venous thrombosis in patients undergoing hip surgery and receiving low molecular weight heparin. [Abstract]. British Journal of Anaesthesia 1995;74 Suppl 1:75.
Brown 1994 {published data only}
  • Brown AG, Visram AR, Jones RDM, Irwins MG, Bacon-Shone J. Preoperative and postoperative oxygen saturation in the elderly following spinal or general anaesthesia - an audit of current practice. Anaesthesia and Intensive Care 1994;22:150-4. [MEDLINE: 1994270545]
Casati 2003 {published data only}
  • Casati A, Aldegheri G, Vinciguerra E, Marsan A, Fraschini G, Torri G. Randomized comparison between sevoflurane anaesthesia and unilateral spinal anaesthesia in elderly patients undergoing orthopaedic surgery. European Journal of Anaesthesiology 2003;20(8):640-6.
Couderc 1977 {published data only}
  • Couderc E, Mauge F, Duvaldestin P, Desmonts J-M. Comparative results of general and peridural anesthesia for hip surgery in the very old patient. [Resultats comparatifs de l'anesthesie generale et peridurale chez le grand vieillard dans la chirurgie de la hanche]. Anesthesie, Analgesie, Reanimation 1977;34(5):987-98. [MEDLINE: 78185115]
Davis 1981 {published data only}
  • Davis FM, Laurenson VG. Spinal anaesthesia or general anaesthesia for emergency hip surgery in elderly patients. Anaesthesia and Intensive Care 1981;9:352-8. [MEDLINE: 1982089249]
  • Davis FM, Quince M, Laurenson VG. Deep vein thrombosis and anaesthetic technique in emergency hip surgery. BMJ 1980;281:1528-9.
Davis 1987 {published data only}
  • Davis FM, Woolner DF, Frampton C, Wilkinson A, Grant A, Harrison RT, et al. Prospective, multi-centre trial of mortality following general or spinal anaesthesia for hip fracture surgery in the elderly. British Journal of Anaesthesia 1987;59:1080-8. [MEDLINE: 1988024611]
de Visme 2000 {published data only}
  • de Visme V, Picard F, Le Jouan R, Legrand A, Savry C, Morin V. Combined lumbar and sacral plexus block compared with plain bupivacaine spinal anesthesia for hip fractures in the elderly. Regional Anesthesia and Pain Medicine 2000;25(2):158-62.
Eyrolle 1998 {published data only}
  • Eyrolle L, Zetlaoui P, Belbachir A, Rosencher N, Conseiller C. Regional anaesthesia for femoral neck fracture surgery: comparison of lumbar plexus block and spinal anaesthesia [Abstract]. British Journal of Anaesthesia 1998;80 Suppl 1:112.
Juelsgaard 1998 {published data only}
  • Juelsgaard P, Sand NP, Felsby S, Dalsgaard J, Jakobsen KB, Brink O, et al. Perioperative myocardial ischaemia in patients undergoing surgery for fractured hip randomized to incremental spinal, single-dose spinal or general anaesthesia. European Journal of Anaesthesiology 1998;15(6):656-63.
Kamitani 2003 {published data only}
  • Kamitani K, Higuchi A, Asashi T, Yoshida H. Postoperative delirium after general anesthesia vs. spinal anesthesia in geriatric patients. Masui - Japanese Journal of Anesthesiology 2003;52(9):972-5.
Maurette 1988 {published data only}
  • Maurette P, Castagnera L, Vivier C, Erny P. Comparative repercussions of general and spinal anesthesia on psychological functions of the aged subject [Repercussions comparees de l'anesthesie generale et de la rachianesthesie sur les fonctions psychiques du sujet age]. Annales Francaises d' Anesthesie et de Reanimation 1988;7:305-8. [MEDLINE: 89075140]
McKenzie 1984 {published and unpublished data}
McLaren 1978 {published data only}
  • McLaren AD. Mortality studies. A review. Regional Anesthesia 1982;7(Suppl 4):S172-4.
  • McLaren AD, Stockwell MC, Reid VT. Anaesthetic techniques for surgical correction of fractured neck of femur: a comparative study of spinal and general anaesthesia in the elderly. Anaesthesia 1978;33:10-4. [MEDLINE: 1978121768]
Racle 1986 {published data only}
  • Racle JP, Benkhadra A, Poy JY, Gleizal B, Gaudray A. Comparative study of general and spinal anesthesia in elderly women in hip surgery [Etude comparative de l'anesthesie generale et de la rachianestesie chez la femme agee dans la chirurgie de la hanche]. Annales Francaises d' Anesthesie et de Reanimation 1986;5:24-30. [MEDLINE: 1986213298]
Spreadbury 1980 {published data only}
  • Spreadbury TH. Anaesthetic techniques for surgical correction of fractured neck of femur: a comparative study of ketamine and relaxant anaesthesia in elderly women. Anaesthesia 1980;35:208-14. [MEDLINE: 1980218116]
Svarting 1986 {published data only}
  • Svartling N, Lehtinen A-M, Tarkkanen, L. The effect of anaesthesia on changes in blood pressure and plasma cortisol levels induced by cementation with methylmethacrylate. Acta Anaesthesiologica Scandinavica 1986;30(3):247-52.
Tasker 1983 {published data only}
  • Tasker TPB, Raitt DG, Kohn RLJ, Vater M, Crawshaw C. Subarachnoid block or general anaesthesia?: a study of the stress response during and after surgery for prosthetic replacement of fractured neck of femur [abstract]. Journal of Bone and Joint Surgery. British Volume 1983;65:660.
Ungemach 1993 {published data only}
  • Ungemach JW, Andres FJ, Eggert E, Schoder K. The role of anaesthesia in geriatric patients with hip fractures: A prospective study. European Journal of Anaesthesiology. 1993; Vol. 10, issue 5:380.
Valentin 1986 {published data only}
Wajima 1995 {published data only}
  • Wajima Z, Kurosawa H, Inoue T, Yoshikawa T, Ishikawa G, Shitara T, et al. Changes in dementia rating scale scores of elderly patients with femoral neck fracture during perioperative period [Japanese]. Masui - Japanese Journal of Anesthesiology 1995;44(11):1489-97.
White 1980 {published data only}

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Alonso Chico 2003 {published data only}
  • Alonso Chico A, Cruz Pardos P, Alvarez Grau J, Pachoco Jimenez A, Arregui Martinez de Lejarza M, Sanchez Garcia ML, et al. Comparison of the hemodynamic response in subarachnoid anesthesia with bupivacaine versus bupivacaine with fentanyl in traumatology surgery in elderly patients [Comparacion de la respuesta hemodinamica en la anestesia subaracnoidea con bupivacaina frente a bupivacaina con fentanilo en cirugia traumatologica en ancianos]. Revista Espanola de Anestesiologia y Reanimacion 2003;50(1):17-22.
Barna 1981 {published data only}
  • Barna B. Comparison of spinal and general anesthesia in the surgical treatment of hip fractures [A spinalis es az altalanos anaesthesia osszehasonlitasa csipotaji toresek multejeinek erzesteleniteseben]. Orvosi Hetilap 1981;122:1135-8.
Ben-David 2000 {published data only}
Coleman 1988 {published data only}
  • Coleman SA, Boyce WJ, Cosh PH, McKenzie PJ. Outcome after general anaesthesia for repair of fractured neck of femur: a randomised trial of spontaneous v. controlled ventilation. British Journal of Anaesthesia 1988;60:43-7.
Critchley 1995 {published data only}
Darling 1994 {published data only}
  • Darling JR, Murray JM, Hainsworth AM, Trinick TR. The effect of isoflurane or spinal anesthesia on Indocyanine green disappearance rate in the elderly. Anesthesia and Analgesia 1994;78:706-9.
Dyson 1988 {published data only}
  • Dyson A, Henderson AM, Chamley D, Campbell ID. An assessment of postoperative oxygen therapy in patients with fractured neck of femur. Anaesthesia and Intensive Care 1988;16:405-10.
El-Zahaar 1995 {published data only}
  • El-Zahaar MS, Al-Kawally HM, Said AS. A double-blind randomized study of the effects of torniquet use and type of anesthetic techniques on the incidence of deep vein thrombosis (DVT) in orthopedic surgery. Journal of Neurological & Orthopaedic Medicine & Surgery 1995;16(2):70-4.
Favarel 1996 {published data only}
  • Favarel Garrigues JF, Sztark F, Petitjean ME, Thicoipe M, Lassie P, Dabadie P. Hemodynamic effects of spinal anaesthesia in the elderly: single dose versus titration through a catheter. Anesthesia and Analgesia 1996;82:312-6.
Hemmingsen 1991 {published data only}
  • Hemmingsen C, Nielsen JE. Intravenous ketamine for prevention of severe hypotension during spinal anaesthesia. Acta Anaesthesiologica Scandinavica 1991;35(8):755-7.
Marhofer 1999 {published data only}
  • Marhofer P, Faryniak B, Oismuller C, Koinig H, Kapral S, Mayer N. Cardiovascular effects of 6% hetastarch and lactated Ringer's solution during spinal anesthesia. Regional Anesthesia & Pain Medicine 1999;24(5):388-404.
Matot 2003 {published data only}
  • Matot I, Oppenheim-Eden A, Ratrot R, Baranova J, Davidson E, Eylon S, et al. Preoperative cardiac events in elderly patients with hip fracture randomized to epidural or conventional analgesia. Anesthesiology 2003;98(1):156-63.
Maurette 1993 {published data only}
  • Maurette P, Bonada G, Djiane V, Erny P. A comparsion between lidocaine alone and lidocaine with meperidine for continous spinal anesthesia. Regional Anesthesia 1993;18:290-5.
Naja 2000 {published data only}
  • Naja Z, el Hassan MJ, Khatib H, Ziade MF, Lonnqvist PA. Combined sciatic-paravertebral nerve block vs. general anaesthesia for fractured hip of the elderly. Middle East Journal of Anesthesiology 2000;15(5):559-68.
Nishikawa 2002 {published data only}
  • Nishikawa K, Yamakage M, Omote K, Namiki A. Prophylactic IM small-dose phenylephrine blunts spinal anaesthesia-induced hypotensive response during surgical repair of hip fracture in the elderly. Anesthesia and Analgesia 2002;95(3):751-6.
Owen 1982 {published data only}
Sinclair 1997 {published data only}
  • Sinclair S, James S, Singer M. Intraoperative intravascular volume optimisation and length of hospital stay after repair of proximal femoral fracture: randomised controlled trial. BMJ 1997;315:909-12.
Sutcliffe 1994 {published data only}
  • Sutcliffe AJ, Parker MJ. Mortality after spinal and general anaesthesia for surgical fixation of hip fractures. Anaesthesia 1994;49:237-40.
Tonczar 1981 {published data only}
  • Tonczar L, Hammerle AF. The impairment of stress parameters by hip joint close operations and the influence of anaesthesia. Preliminary results of a prospective study (author's translation) [Auswirkungen huftgelenksnaher operationen auf das verhalten von stressparametern und ihre beeinflussung durch anasthesie. Vorlaufige ergebnisse einer prospektiven studie]. Unfallchirurgie 1981;7(3):138-41.
Ungemach 1987 {published data only}
  • Ungemach JW. Inhalation anesthesia or "balanced anesthesia"? A comparative perioperative study in geriatric patients [Inhalationsanaesthesie oder " balancierte anaesthesie "?: Eine vergleichende perioperative studie geriatrischer patienten]. Anaesthesist 1987;36:288-91.
Van Gessel 1989 {published data only}
  • Van Gessel EF, Forster A, Gamulin Z. Surgical repair of hip fractures using continuous spinal anesthesia: comparison of hypobaric solutions of tetracaine and bupivaciane. Anesthesia and Analgesia 1989;68(3):276-81.
Wickstrom 1982 {published data only}
  • Wickstrom I, Holmberg I, Stefansson T. Survival of female geriatric patients after hip fracture surgery. A comparison of 5 anesthetic methods. Acta Anaesthesiologica Scandinavica 1982;26:607-14.

References to studies awaiting assessment

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Dougall 1988 {published data only}
  • Dougall JR, Caird FI, Wishart HY, Spence AA. Spinal versus general anaesthesia for patients with femoral neck fractures: studies of post-operative physical and mental well-being [abstract]. European Journal of Anaesthesiology 1988;5:52.
Yao 1997 {published data only}
  • Yao CZ, Zhang Z, Diao YC, Zhu C, Jin MC. Surgical repair of the fracture of neck of femur using spinal anesthesia with hypobaric bupivacaine [Original title in Chinese]. Chinese Journal of Anesthesiology 1997;17(5):306-7.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Alderson 2004a
  • Alderson P, Green S, Higgins JPT, editors. MEDLINE highly sensitive search strategies for identifying reports of randomized controlled trials in MEDLINE. Cochrane Reviewers' Handbook 4.2.2 [updated March 2004]; Appendix 5b. In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd. Oxford.
Alderson 2004b
  • Alderson P, Green S, Higgins JPT, editors. Quality assessment of studies. Cochrane Reviewers' Handbook 4.2.2 [updated March 2004]; Section 6. In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd..
Ballantyne 2004
  • Ballantyne J. personal communication June 13 2004.
Carlisle 2004
  • Carlisle J. personal communication June 2004.
Covert 1989
  • Covert CR, Fox GS. Anaesthesia for hip surgery in the elderly. Canadian Journal of Anaesthesia 1989;36:311-9.
Higgins 2003
Higham 2001
  • Higham H, Mishra P, Foex P. Reduction of postoperative mortality and morbidity. Research into modern anaesthesia techniques and perioperative medicine is needed [multiple letters]. BMJ 2001;322(7295):1182.
Hughes 2000
  • Hughes JC, Barratt S, Jonathan R, Wilson T, Hollis S, Norris A, et al. Rapid responses to Rodgers A, Walker N, Schug S, McKee A, Kehlet H, van Zundert A, et al. Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials. BMJ 2000;321:1493-7. Available at: http://bmj.bmjjournals.com/cgi/content/full/321/7275/1493#responses (accessed 19/08/2004).
Mansour 1993
McCullock 2001
Melton 1993
  • Melton LJ III. Hip fractures: a worldwide problem today and tomorrow. Bone 1993;14 Suppl 1:S1-8.
Modig 1983
Modig 1988
  • Modig J. Regional anaesthesia and blood loss. Acta Anaesthesiologica Scandinvica Supplementum 1988;89:44-8.
Oxman 2001
  • Oxman AD. The Cochrane Collaboration in the 21st century: ten challenges and one reason why they must be met. In: Egger M, Davey Smith G, Altman DG editor(s). Systematic reviews in health care. Meta-analysis in context. 2nd Edition. London, UK: BMJ, 2001:459-73.
Parker 1993
  • Parker MJ, Pryor GA. Hip fracture management. Oxford: Blackwell Scientific Publications, 1993.
Parker 2001
  • Parker MJ, Griffiths R, Appadu BN. Nerve blocks (subcostal, lateral cutaneous, femoral, triple, psoas) for hip fractures (Cochrane Review). Cochrane Database of Systematic Reviews 2001, Issue 3.
Rodgers 2000
  • Rodgers A, Walker N, Schug S, McKee A, Kehlet H, van Zundert A, et al. Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials. BMJ 2000;321:1493-7.
Sorensen 1992
WHO study group 1994
  • WHO study group. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. WHO; 1994 WHO technical report series no.: 843.
Winnie 1974
  • Winnie AP, Ramamurthy S, Durrani Z, Radonjic R. Plexus blocks for lower extremity surgery. Anesthesiology Reviews 1974;1:11-6.

References to other published versions of this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
  5. References to other published versions of this review
Urwin 2000
  • Urwin SC, Parker MJ, Griffiths R. General versus regional anaesthesia for hip fracture surgery: a meta-analysis of randomized trials. British Journal of Anaesthesia 2000;84(4):450-5.