General versus regional anaesthesia for hip fractures. A pilot randomised controlled trial of 322 patients.

Uncertainty remains regarding the optimum method of anaesthesia for hip fracture surgery. We randomised 322 patients with a hip fracture to receive either general anaesthesia or regional (spinal) anaesthesia. Surviving patients were followed up to 1 year from injury. There was no notable difference in the outcomes of hospital stay, need for blood transfusion or post-operative complications between groups. 30-day mortality was marginally reduced for spinal anaesthesia 7/164(4.3%) versus 5/158(3.2%) (p=0.57), whilst at 1 year it was less for general anaesthesia 20/163(12.1%) versus 32/158(20.2%) (p=0.05). Within the confines of the limited patient numbers studied we conclude that there are no marked differences in outcome between the two techniques.