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 .
[Epidural vs general anaesthesia].
BACKGROUND Aim of this study is to determine if and how the anaesthesia technique can significantly influence the outcome in patients after major orthopaedic surgery in terms of : patrimony of red blood cells ( blood loss and erythropoiesis ) , incidence of intra and postoperative complications , postoperative pain control and hospital stay . METHODS 210 patients , ASA physical status I-III , undergoing elective primary total hip replacement were r and omly allocated in three groups of 70 patients to receive either epidural anaesthesia ( Group EA ) , general anaesthesia ( GA ) , or epidural anaesthesia integrated with mild general anaesthesia ( IA ) . RESULTS Data show a significant difference between the amount of pain measured by VRS immediately after surgery : prevalently absent in groups IA ( 84.3 % ) and EA ( 85.7 % ) and prevalently severe and moderate in group AG ( 34.3 % ) . The measurement of the basic circulating erythrocyte mass in the first , third and fifth postoperative day , calculated by the Mercuriali formula , which considers blood loss , autologous and homologous transfusions and erythropoiesis , showed that general anaesthesia leads to a significant delay in the resumption of haemopoiesis . This result was attenuated by its combination with epidural anaesthesia . CONCLUSIONS On the basis of the literature and the results of our study , epidural anaesthesia seems to be the most appropriate technique for patients scheduled for total hip replacement : due to its simpler analgesic cover , its tendency to be associated with a lower incidence of complications in the first 24 hours after surgery . The incidence of relevant hypotension is minor compared to integrated anaesthesia . General anaesthesia produced a significant decrease in postoperative erythropoiesis
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 .