Individual research recommendation details

Recommendation ID

CG124/02

Question

Anaesthesia: What is the clinical and cost effectiveness of regional versus general anaesthesia on postoperative morbidity in people with hip fracture?

Any explanatory notes
(if applicable)

Why this is important?
No recent randomised controlled trials were identified that fully address this question. The evidence is old and does not reflect current practice. In addition, in most of the studies the patients are sedated before regional anaesthesia is administered, and this is not taken into account when analysing the results. The study design for the proposed research would be best addressed by a randomised controlled trial. This would ideally be a multicentre trial including 3,000 participants in each arm. This is achievable given that there are about 70,000 to 75,000 hip fractures a year in the UK. The study should have 3 arms that look at spinal anaesthesia versus spinal anaesthesia plus sedation versus general anaesthesia; this would separate those with regional anaesthesia from those with regional anaesthesia plus sedation. The study would also need to control for surgery, especially type of fracture, prosthesis and grade of surgeon.

A qualitative research component would also be helpful to study patient preference for type of anaesthesia.

Source guidance details

Comes from guidance

Hip fracture: management

Number

CG124

Date issued

June 2011

Other details