Long term effect of general and regional anesthesia on bone turnover markers and fracture healing in adult patients

Purpose: Bone metabolism can be monitored quantitatively by measuring bone turnover markers in serum and/or urine. We aimed to investigate long-term effect of the type of the anesthesia on bone turnover markers and fracture healing Materials and Methods:Thirty patients with American Society of Anesthesiologist physical status I-II whom were aged 40-70 years, scheduled for hip fracture were recruited. Patients were divided into the two groups as general anesthesia and regional anesthesia. Only morphine and tramadol were used for postoperative analgesia till the 12th weeks. Serum bone-specific alkaline phosphatase, osteocalcine, β-C terminal telopeptide and urine β-C terminal telopeptide levels were measured at preoperative, 4.th week and 12.th week of fracture. Results:A total of 25 patients were eligible for the study. There were no statistically significant between groups for values of bone turnover markers at the time point of preoperative, 4.th and 12.th weeks. With using linear regression analysis, serum β-CTX levels at 12.th week can be predict by 4.th weeks β-CTX levels (R2: 0.944) and urine β-CTX levels at 12.th week can be predicted by first week level. Conclusion: This pilot study showed that both general and regional anesthesia has similar effect on bone turnover markers and fracture healing