Spinal anesthesia contributed to more intense pain after surgery


The intensity of pain after general anesthesia was less than after spinal anesthesia for hip surgery. The type of anesthesia affected the number of prescription analgesics prescribed to the patient.

According to a study published in the Annals of Internal Medicine, pain during the first 24 hours after surgery to repair a hip fracture was higher with spinal anesthesia than with general anesthesia.

The indicators were assessed in patients from the previous REGAIN study, which included data from 1600 patients aged 50 years and older. Surgery for clinically or radiographically confirmed intertrochanteric or subtrochanteric femoral neck fractures was performed in 46 hospitals in the United States and Canada.

Patients’ pain scores during the first 24 hours after surgery were higher with spinal anesthesia (mean 7.9) compared to general anesthesia (mean 7.6). Pain scores did not differ between groups later after surgery. Opioid analgesic use within 60 days was higher for surgery under spinal anesthesia compared with general anesthesia. Evaluation of the indicator at a later date did not reveal any differences.

Principal investigator Professor Mark Neuman from the University of Pennsylvania commented to Medscape: Spinal and general anesthesia have been used for decades, but patients and doctors lacked reliable information on key indicators such as pain and satisfaction after surgery.

Primary analysis of data from the REGAIN trial found similar ambulation and 60-day survival between spinal and general anesthesia for hip fracture surgery. Patients who required a concurrent procedure when spinal anesthesia was not possible, had a periprosthetic fracture, had a contraindication to spinal anesthesia, and were unable to walk 10 feet without assistance before the fracture were excluded from the study.



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