Spinal versus General Anesthesia for Hip Fracture

CA-2 · I.C.1.a.2.a I.C.1.a.2.b I.A.4.a

9Sources
4Kept
0Dropped

1 · Find evidence

PubMed query

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9 candidate papers

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Same-day build

PubMed query

Runs the tiered searches, drafts one point per included paper, runs the citation gate and builds a draft deck — the steps below, unattended. Same-day build — drafted locally (medgemma:27b), confirmed against each abstract. The deck still lands in draft: nothing here approves anything.

2 · Teaching points

Source

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4 points

Preoperative peripheral nerve blocks reduce hip fracture pain at two hours, and the pericapsular nerve group block outperformed femoral and fascia iliaca blocks, though most evidence was low confidence. PMID 38385910 kept
In REGAIN, spinal anaesthesia was not superior to general for hip fracture: death or inability to walk at 60 days occurred in 18.5% versus 18.0%, and delirium in 20.5% versus 19.7%. PMID 34623788 kept
REGAIN's pain analysis found spinal anaesthesia gave slightly worse worst-pain in the first 24 hours and more prescription analgesic use at 60 days (25% versus 18.8%) than general anaesthesia. PMID 35696684 kept
Two randomised trials totalling 2,550 patients found no mortality benefit, no less delirium and no better ambulation with spinal anaesthesia, so telling a patient that spinal is the safer choice is not supported. PMID 36977525 kept

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