‘Peripheral nerve blocks vs selective spinal anesthesia in patients with femur fracture’ - Uncertain evidence of superiority

Description

Maja Kovac writes a 2026 letter to the editor examining a randomised trial that compared two anaesthetic techniques for thigh-bone fracture surgery: peripheral nerve blocks and selective spinal anaesthesia. The trial's authors reported differences including more episodes of low blood pressure under spinal anaesthesia. Kovac questions whether the groups were truly comparable and whether the measurements support the conclusions drawn.

One concern is case mix: eighty percent of the spinal group carried high anaesthetic-risk grades, against a notably smaller share in the block group, which could itself explain extra blood-pressure drops. A second concern is repeated testing of block strength in sedated patients during surgery, a practice needing cooperation and unclear rationale. The letter asks for clearer reporting before superiority is claimed either way.

Catalog record

Source: https://europepmc.org/articles/PMC13227677