Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery

LettersJanuary 2023Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture SurgeryYu Toda, MD, PhD, Hiroto Ishiki, MD, Taku Machida, MD, Naruaki Kawasaki, MD, Eisuke Kobayashi, MD, PhDYu Toda, MD, PhDDepartment of Palliative Medicine and Department of Musculoskeletal Oncology and Rehabilitation Medicine, National Cancer Center Hospital, Tokyo, JapanSearch for more papers by this author, Hiroto Ishiki, MDDepartment of Palliative Medicine, National Cancer Center Hospital, Tokyo, JapanSearch for more papers by this author, Taku Machida, MDDepartment of Palliative Medicine, National Cancer Center Hospital, Tokyo, JapanSearch for more papers by this author, Naruaki Kawasaki, MDDepartment of Palliative Medicine, National Cancer Center Hospital, Tokyo, JapanSearch for more papers by this author, Eisuke Kobayashi, MD, PhDDepartment of Musculoskeletal Oncology and Rehabilitation Medicine, National Cancer Center Hospital, Tokyo, JapanSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L22-0366 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR: Neuman and colleagues (1) report the results of a randomized clinical trial that compared spinal with general anesthesia. The spinal anesthesia group had more pain in the first 24 hours after surgery and more analgesic use 60 days after surgery. Because this was an open-label trial, many biases could have affected the results. To better interpret the authors' findings, the following discussion points should be addressed.First, we are concerned about the reliability of questionnaires in patients with dementia and delirium. In this study, the essential end points were patient-reported outcomes. More than 10% of patients enrolled ...References1. Neuman MD, Feng R, Ellenberg SS, et al; REGAIN (Regional versus General Anesthesia for Promoting Independence after Hip Fracture) Investigators. Pain, analgesic use, and patient satisfaction with spinal versus general anesthesia for hip fracture surgery. A randomized clinical trial. Ann Intern Med. 2022;175:952-60. [PMID: 35696684] doi:10.7326/M22-0320 LinkGoogle Scholar2. American Geriatrics Society Expert Panel on Postoperative Delirium in Older Adults. Postoperative delirium in older adults: best practice statement from the American Geriatrics Society. J Am Coll Surg. 2015;220:136-48.e1. [PMID: 25535170] doi:10.1016/j.jamcollsurg.2014.10.019 CrossrefMedlineGoogle Scholar3. Smith TO, Cooper A, Peryer G, et al. Factors predicting incidence of post-operative delirium in older people following hip fracture surgery: a systematic review and meta-analysis. Int J Geriatr Psychiatry. 2017;32:386-96. [PMID: 28093812] doi:10.1002/gps.4655 CrossrefMedlineGoogle Scholar4. Baron R, Binder A, Wasner G. Neuropathic pain: diagnosis, pathophysiological mechanisms, and treatment. Lancet Neurol. 2010;9:807-19. [PMID: 20650402] doi:10.1016/S1474-4422(10)70143-5 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Yu Toda, MD, PhD; Hiroto Ishiki, MD; Taku Machida, MD; Naruaki Kawasaki, MD; Eisuke Kobayashi, MD, PhDAffiliations: Department of Palliative Medicine and Department of Musculoskeletal Oncology and Rehabilitation Medicine, National Cancer Center Hospital, Tokyo, JapanDepartment of Palliative Medicine, National Cancer Center Hospital, Tokyo, JapanDepartment of Musculoskeletal Oncology and Rehabilitation Medicine, National Cancer Center Hospital, Tokyo, JapanDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L22-0366. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery Mark D. Neuman , Rui Feng , Susan S. Ellenberg , Frederick Sieber , Daniel I. Sessler , Jay Magaziner , Nabil Elkassabany , Eric S. Schwenk , Derek Dillane , Edward R. Marcantonio , Diane Menio , Sabry Ayad , Manal Hassan , Trevor Stone , Steven Papp , Derek Donegan , Mitchell Marshall , J. Douglas Jaffe , Charles Luke , Balram Sharma , Syed Azim , Robert Hymes , Ki-Jinn Chin , Richard Sheppard , Barry Perlman , Joshua Sappenfield , Ellen Hauck , Mark A. Hoeft , Ann Tierney , Lakisha J. Gaskins , Annamarie D. Horan , Trina Brown , James Dattilo , and Jeffrey L. Carson , on behalf of the REGAIN (Regional versus General Anesthesia for Promoting Independence after Hip Fracture) Investigators* Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery Mark D. Neuman , Susan S. Ellenberg , Jeffrey L. Carson , Frederick E. Sieber Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery Joel Yarmush , Mohamed Ehab Ramadan Metrics January 2023Volume 176, Issue 1KeywordsAnalgesicsAnesthesiaAnesthesiologyGeneral anesthesiaHip fracturesHospital medicineSurgery ePublished: 17 January 2023 Issue Published: January 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...