So far , the evidence available from the studies included is insufficient to prove that neuraxial anesthesia is more effective and safer than general anesthesia for orthopedic surgery .
However , this systematic review does not rule out clinical ly important differences with regard to mortality , stroke , myocardial infa rct ion , length of hospitalization , postoperative cognitive dysfunction or pneumonia
CONTEXT AND OBJECTIVE Taking the outcome of mortality into consideration , there is controversy about the beneficial effects of neuraxial anesthesia for orthopedic surgery .
The aim of this study was to compare the effectiveness and safety of neuraxial anesthesia versus general anesthesia for  orthopedic surgery .
Spinal Versus General Anesthesia for Orthopedic Surgery: Anesthesia Drug and Supply Costs
Total hip or knee replacement surgeries are common orthopedic interventions that can be performed with spinal anesthesia ( SA ) or general anesthesia ( GA ) . No study has investigated the economic aspects associated with the two anesthetic techniques for this common surgery . We r and omized 40 patients to receive either SA or GA  and analyzed the drug and supply costs for anesthesia und recovery . Anesthesia-related times , hemodynamic variables , and pain scores were also recorded . Total costs per case without personnel costs were almost half in the SA group compared with the GA group ; this was a result of less cost for anesthesia ( P < 0.01 ) and for recovery ( P < 0.05 ) . This finding was supported by a sensitivity analysis . There were no relevant differences regarding anesthesia-related times . Patients in the GA group were admitted to the postanesthesia care unit with a higher pain score and needed more analgesics than patients in the SA group ( both P < 0.01 ) . We conclude that SA is a more cost-effective alternative to GA in patients undergoing hip or knee replacement , as it is associated with lower fixed and variable costs . Moreover , SA seems to be more effective , as patients in the SA group showed lower postoperative pain scores during their stay in the postanesthesia care unit
So far , the evidence available from the studies included is insufficient to prove that neuraxial anesthesia is more effective and safer than general anesthesia for orthopedic surgery .
However , this systematic review does not rule out clinical ly important differences with regard to mortality , stroke , myocardial infa rct ion , length of hospitalization , postoperative cognitive dysfunction or pneumonia
CONTEXT AND OBJECTIVE Taking the outcome of mortality into consideration , there is controversy about the beneficial effects of neuraxial anesthesia for orthopedic surgery .
The aim of this study was to compare the effectiveness and safety of neuraxial anesthesia versus general anesthesia for  orthopedic surgery .