The effect of the preferred anesthesia method on early postoperative outcomes in elderly patients with hip fractures; a retrospective three-way comparative study

BACKGROUND: Pertrochanteric femoral fractures in the elderly are associated with high morbidity and delayed recovery. The type of anesthesia used during surgical fixation may significantly impact postoperative outcomes. The erector spinae plane (ESP) block has recently emerged as a promising alternative to traditional techniques. METHODS: This retrospective study evaluated 64 patients who underwent proximal femoral nailing (PFN) and received either general anesthesia (GA), spinal anesthesia (SA), or ESP block. Pain (VAS), function (Harris and Oxford Hip Scores), quality of life (EQ-5D), complication rates, mobilization time, and hospital stay were compared. RESULTS: All groups showed improvement, but the ESP block group had significantly lower pain scores (p < 0.001), better functional outcomes, earlier mobilization, and shorter hospital stays. Complications such as urinary retention and delirium were more frequent in the GA group. CONCLUSION: ESP block provided superior pain control, enhanced functional recovery, and fewer complications in patients undergoing PFN. It represents a safe and effective alternative in the anesthetic management of elderly patients with fragility fractures.