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Clinicians have long debated preferences for spinal or general anesthesia in patients who are undergoing surgery for hip fracture. In a recent randomized trial (REGAIN), 1600 mostly community-dwelling patients (mean age, 78) with hip fracture received either spinal or general anesthesia for hip-fracture surgery, and no meaningful short-term differences between the two approaches were noted for mortality, delirium, and ambulation (NEJM JW Gen Med Dec 1 2021 and N Engl J Med 2021; 385:2025). However, these older patients often have substantial comorbidities, and they might be particularly susceptible to subclinical perioperative adverse events (e.g., myocardial or cerebrovascular ischemia) that might not become apparent until later in the yea…