Evidence map›Paper›PMID 37753546›Full record

SynthesisOrthopaedic surgery2023

Comparing the Effect of Spinal and General Anesthesia for Hip Fracture Surgery in Older Patients: A Meta-analysis of Randomized Clinical Trials.

Hua Lin, Ying Zhu, Cheng Ren, Teng Ma, Ming Li, Zhong Li, Yibo Xu, Qian Wang, Jing Hu, Kun Zhang

Open access · goldAbstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Orthopaedic surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.5field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Hua LinDepartment of Orthopedic Trauma, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.
Ying ZhuDepartment of Neurology, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.
Cheng RenDepartment of Orthopedic Trauma, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.ORCID https://orcid.org/0000-0001-7514-4939
Teng MaDepartment of Orthopedic Trauma, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.
Ming LiDepartment of Orthopedic Trauma, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.ORCID https://orcid.org/0000-0002-4411-7791
Zhong LiDepartment of Orthopedic Trauma, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.
Yibo XuDepartment of Orthopedic Trauma, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.ORCID https://orcid.org/0000-0003-4923-4820
Qian WangDepartment of Orthopedic Trauma, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.
Jing HuDepartment of Nursing, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.
Kun ZhangDepartment of Orthopedic Trauma, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.
Xi'an Honghui Hospital · CN

Funding

Shaanxi Province Natural Science Fundamental Research Project 2022JQ-299Shaanxi Province Natural Science Fundamental Research Project 2022JQ-759
6 · The paper itself

Abstract

objectiveHip fractures are the most common fractures among older adults, with most patients undergoing surgery. The debate regarding the type of anesthetic technique for hip fracture surgery is still ongoing. This meta-analysis aimed to compare the intraoperative and postoperative outcomes of spinal and general anesthesia in older patients undergoing hip fracture surgery.

methodsEligible studies that compared the effects of spinal and general anesthesia were systematically searched from PubMed, Embase, and the Cochrane Library until May 27, 2022. The intraoperative and postoperative outcomes of the two anesthesia techniques were compared. Quality assessment, heterogeneity analysis, and publication bias of the studies were also assessed.

resultsNine articles of methodological quality were included in the meta-analysis. The pooled results revealed that there were significant differences in hypotension (risk ratio [RR] (95% confidence interval [CI]) = 0.81 (0.68, 0.97), p = 0.02) and ephedrine dose (weighted mean difference [WMD] [95%CI] = -20.94 [-37.50, -4.37] mg, p = 0.01) between the spinal and general anesthesia groups. However, no significant differences were observed in the use of ephedrine (RR [95% CI] = 0.77 [0.19, 3.05]), blood loss (WMD [95%CI] = -34.38 [-89.56, 20.80) mL], myocardial infarction (RR [95% CI] = 0.78 [0.31, 1.94] mL), heart failure (RR [95% CI] = 0.87 [0.17, 4.36] mL), stroke (RR [95%CI) = 0.65 [0.22, 1.95] mL), postoperative nausea and vomiting (RR [95% CI] = 0.88 [0.17, 4.35] mL), delirium (RR [95% CI] = 1.08 [0.89, 1.31] mL), and mortality (RR [95% CI] = 1.10 [0.72, 1.68] mL) (all p < 0.05). No publication bias was observed in any of the included studies.

conclusionCompared to general anesthesia, spinal anesthesia was associated with a lower risk of intraoperative hypotension and lower doses of ephedrine in older patients undergoing hip fracture surgery.

Indexed as

Anesthesia, SpinalHip FracturesHypotensionAgedAnesthesia, GeneralEphedrineHumansRandomized Controlled Trials as TopicEphedrineEphedrineHypotensionIntraoperative outcomesOlder populationPostoperative outcomes

Identifiers

PMID37753546
PMCPMC10693995
OpenAlexW4387077823

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.