This prospective observational study aims to compare total intravenous anesthesia (TIVA) with sevoflurane-based inhalational anesthesia in patients aged 65 years and older undergoing hip fracture surgery under general anesthesia. The study will evaluate postoperative quality of recovery using the Quality of Recovery-40 (QoR-40) questionnaire and cognitive outcomes, including postoperative delirium and cognitive status. Pain scores, opioid consumption, recovery room stay, postoperative complications, and patient satisfaction will also be recorded. The anesthesia technique will be determined by the attending anesthesiologist as part of routine clinical practice, and the researchers will not interfere with the choice of anesthesia.
Age 65 years or older
ASA physical status I-III
Scheduled to undergo elective or emergency hip fracture surgery under general anesthesia
Provision of informed consent by the patient and/or legal representative
Refusal to participate in the study
ASA physical status IV-V
Severe pre-existing neurological or psychiatric disorders, including advanced dementia or severe cognitive impairment preventing communication
Known hypersensitivity or allergy to propofol or sevoflurane
Patients aged 65 years or older undergoing hip fracture surgery under general anesthesia at Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital. Participants will be observed according to the anesthesia technique used as part of routine clinical practice: propofol-based total intravenous anesthesia or sevoflurane-based inhalational anesthesia.
Cohort
Prospective
Propofol-based Total Intravenous Anesthesia
Other interventionPropofol-based total intravenous anesthesia administered according to routine clinical practice during hip fracture surgery.
Sevoflurane-based Inhalational Anesthesia
Other interventionSevoflurane-based inhalational anesthesia administered according to routine clinical practice during hip fracture surgery.
Quality of Recovery-40 (QoR-40) Score on Postoperative Day 1
Postoperative quality of recovery will be assessed using the Quality of Recovery-40 (QoR-40) questionnaire. The QoR-40 consists of 40 items evaluating five dimensions of recovery: physical comfort, emotional state, physical independence, psychological support, and pain. Higher total scores indicate better quality of recovery.
Quality of Recovery-40 (QoR-40) Score on Postoperative Day 2
Quality of recovery will be reassessed using the QoR-40 questionnaire.
Incidence of Postoperative Delirium
Postoperative delirium will be assessed using the 3D-CAM assessment.
Postoperative Pain Intensity
Postoperative pain intensity will be evaluated using the Numerical Rating Scale (NRS).
Postoperative Opioid Consumption
Total postoperative opioid consumption will be recorded from routine clinical records.
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