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 .
A Prospective Randomized Study Comparing Short- and Intermediate-Term Perioperative Outcome Variables After Spinal or General Anesthesia for Lumbar Disk and Laminectomy Surgery
General or regional anesthesia may be used for lumbar laminectomy . To determine whether one method is superior , 122 patients were r and omly assigned to receive either a  st and ard general anesthetic ( GA ) or spinal anesthesia ( SA ) supplemented with intravenous ( IV ) propofol sedation . Data from the intraoperative period through hospital discharge were collected and compared . Demographically , both groups were similar .  Total anesthesia ( 131.0 + /- 4.3 vs 106.6 + /- 3.2 min ) and surgical times ( 81.5 + /- 3.6 vs 67.1 + /- 2.8 min ) were longer in the GA group . Intraoperative hemodynamics were similar between groups except that the incidence of increased blood pressure was more frequent with GA ( 26.2 % vs 3.3 % ) . Blood loss was less during SA ( 133 + /- 18 mL vs 221 + /- 32 mL ) . Postanesthesia care unit ( PACU ) heart rates and mean arterial pressures were higher in the GA group . Peak pain scores in the PACU were higher after GA compared with SA ( 58 + /- 4 vs 22 + /- 3 ) as were the number of patients who required analgesics . Severe nausea was more common in the GA group both in the PACU and during the 24 h after surgery . Analgesic requirements after discharge from the PACU , urinary retention , and days in the hospital did not differ between groups . This study suggests that SA may be superior to GA both intraoperatively and postoperatively for lumbar spine procedures lasting less than 2 h. ( Anesth Analg 1996;83:559 - 64
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 .