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 or General Anesthesia for Surgery of the Fractured Hip? A Prospective Study of Mortality in 578 Patients
The mortality following surgical correction of upper femoral fractures was investigated in 578 patients , over the age of 50 yr , r and omly allocated to receive spinal ( bupivacaine ) or general ( enflurane or neurolept ) anaesthesia .  Thirty days after surgery the mortality was 6 % after spinal and 8 % after general anaesthesia ( ns ) . Six months to 2 years after surgery the mortality was identical in the two groups . There were no differences with respect to ambulation and discharge . The estimated blood loss was smaller ( P less than 0.05 ) in patients receiving spinal anaesthesia .  Regardless of the anaesthetic technique , a high short-term mortality was related to age , male sex , and trochanteric fracture , whereas excess long-term mortality was related to male sex and high ASA scores
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 .