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A recent randomized clinical trial from the U.S. and Canada showed no difference between spinal and general anesthesia for hip fracture surgery outcomes (i.e., hospital length of stay [LOS] and mortality or mobility at 60 days; NEJM JW Gen Med Dec 1 2021 and N Engl J Med 2021; 385:2025). Now, to assess postoperative pain and short- and longer-term prescription analgesic use, investigators performed a prespecified secondary analysis of the same data.
Three fourths of the 1600 patients reported severe pain (≥7 out of 10 severity) within the first 24 hours of surgery; in this group, spinal anesthesia was associated with significantly higher scores than was general anesthesia (average pain scores, 7.9 vs. 7.6). However, pain-score differences we…