Total Intravenous Versus Inhalational Anesthesia in Patients Undergoing Hip Fracture Surgery

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.

Inclusion Criteria: * 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 Exclusion Criteria: * 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 * History of chronic heavy opioid or sedative substance use * Inability to communicate in Turkish or to understand and complete the QoR-40 questionnaire