Regional vs general anaesthesia in orthopaedics

It becomes difficult to develop a cogent argument (from the literature regarding patient outcome) for regional anaesthesia in preference to general anaesthesia for orthopaedic surgery. For deep venous thrombosis, it may be that the attendant medical care of the patient should be altered rather than the anaesthetic technique. Advantages of regional anaesthesia may be short-lived, and overwhelmed by the myriad of other factors coming into play, as with blood loss and perioperative delirium. Even nausea and vomiting are not clearly reduced by the use of the techniques. The persistence of the belief in the superiority of regional anaesthesia may represent a case of our unwillingness to “abandon a perfectly good theory simply because it is wrong,” or it may be that we simply have not asked the appropriate question to elucidate a common impression. This latter remains a challenge.