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 .
Immediate and long-term mental recovery from general versus epidural anesthesia in elderly patients.
The postoperative course of mental performance during the first week and at 3 months after operation was studied in 30 patients above the age of 60 , undergoing total hip replacement arthroplasty . The patients were r and omly allocated to receive either general anesthesia , epidural analgesia , or general anesthesia plus epidural analgesia . The surgically induced increase in plasma cortisol and glucose was inhibited in the two groups receiving epidural analgesia . Mental performance was studied with psychological methods . An equal degree of postoperative impairment of mental performance of 3 - 4 days ' duration was found in all groups . Three months after surgery , mental function had improved slightly and to the same extent in all groups . We conclude that the after surgery , mental function had improved slightly and to the same extent in all groups . We conclude that the transient mental impairment occurring within the first postoperative week is caused by factors other than general anesthetic agents and the endocrine-metabolic response to surgery
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 .