Anesthetic Management in Patients with Hip Fracture.

Abstract

Introduction: Anesthesia in hip surgeries for elderly patients plays an essential role in pain management and the reduction of postoperative complications, such as delirium and cognitive dysfunction. Objective: This study seeks to identify the most effective anesthetic practices for these surgeries. Methodology: A detailed literature review was conducted in key databases, analyzing studies from 2020 to 2024 that compare regional and general anesthesia. The selection included original studies, systematic reviews, and clinical trials, strictly in English and Spanish. Results: No significant differences in postoperative delirium rates were observed between anesthesia techniques. However, regional anesthesia presents fewer pulmonary and hemodynamic complications. Advances such as the pericapsular nerve block (PENG) and the use of ciprofol demonstrate improvements in analgesia and hemodynamic stability. Discussion: Although regional anesthesia is often associated with fewer pulmonary complications, the evidence is mixed regarding its impact on delirium. Geographic variations and the differential use of general anesthesia in some countries highlight the need to standardize evidence-based practices. Conclusion: Personalized techniques based on the patient's profile should be considered. Regional anesthesia offers benefits regarding hemodynamics and pulmonary complications. Emerging techniques and agents like PENG and ciprofol offer additional benefits.