A Retrospective Study on the Impact of Two Anesthesia Methods on Postoperative Outcomes in Elderly Patients Undergoing Lower Limb Orthopedic Surgery

OBJECTIVE: This study aims to assess the impact of general anesthesia versus epidural anesthesia on clinical outcomes in elderly orthopedic patients undergoing lower limb surgeries. METHODS: This retrospective study included patients aged ≥ 75 years who underwent hip, knee, and femoral shaft surgeries at the Third Affiliated Hospital of Sun Yat-sen University. Patients were divided into two groups based on the anesthetic technique: general anesthesia group and epidural anesthesia group. Patient demographic information, intraoperative clinical parameters, and postoperative complications were collected through the medical record system, and logistic regression analysis was used to explore the impact of anesthesia type on postoperative complications. RESULTS: Patients in the epidural anesthesia group had better postoperative recovery compared to the general anesthesia group, as evidenced by shorter stay times in the post-anesthesia care unit (PACU) and lower intensive care unit (ICU) admission rates. The incidence of postoperative pulmonary infection (5.8% vs. 14.5%) and complications (7.3% vs. 16.4%) was significantly lower in the epidural anesthesia group compared to the general anesthesia group. Additionally, logistic regression analysis showed that the risk of postoperative pulmonary infection was significantly higher in the general anesthesia group (OR = 2.208, 95% CI: 1.050-5.135), and the risk of pulmonary complications was also increased (OR = 1.793, 95% CI: 1.080-3.982). In contrast, no significant differences were observed between the two groups in postoperative pain management or cardiovascular-related complications. CONCLUSION: For orthopedic patients aged 75 years and older, epidural anesthesia provides significant advantages in terms of postoperative recovery, particularly in reducing postoperative pulmonary infections and complications. General anesthesia was associated with a higher risk of these adverse outcomes. Therefore, epidural anesthesia may be a safer option for high-risk elderly patients undergoing lower limb orthopedic surgery.