Spinal anaesthesia for surgical correction of fracture of the proximal femur

One hundred and one patients underwent surgical correction of fractures of the proximal femur under spinal anaesthesia. There were 14 deaths in the first three months following surgery. Advancing age, poor pre-anaesthetic status, reduced pre-operative mobility and deteriorating mental function were reliable prognostic indicators of fatal outcome. Spinal anaesthesia for this type of surgery may well be the technique of choice because it avoids the use of drugs which depress the respiratory, cardiac and central nervous system. It also reduces the need for potent post-operative analgesics with similar depressant effects, and may afford some protection against thromboembolic complications. The very low early mortality in this series testifies to the safety of the anaesthetic technique.