Background: Lower limb surgeries can be performed under either spinal anesthesia (SA) or general anesthesia (GA). Selecting the optimal anesthetic technique depends on patient factors, surgical requirements, hemodynamic stability, postoperative pain control, and recovery profile.

Aim: To compare perioperative outcomes, hemodynamic stability, postoperative analgesia, complications, and recovery time between spinal and general anesthesia in lower limb surgeries.

Methods: A prospective comparative study was conducted on 100 patients undergoing elective lower limb surgeries. Patients were randomly allocated into two groups: Group SA (Spinal Anesthesia, n=50) and Group GA (General Anesthesia, n=50). Hemodynamic parameters, surgery duration, onset of anesthesia, postoperative pain (VAS score), complications, recovery time, and length of hospital stay were recorded. Statistical significance was set at p < 0.05.

Results: Group SA showed better hemodynamic stability, significantly lower VAS pain scores at 6 and 12 hours postoperatively (p < 0.01), and shorter recovery time (p = 0.03). Group GA had a higher incidence of postoperative nausea/vomiting (18% vs 4%; p = 0.02). However, GA provided faster induction and was preferred for patients with contraindications to spinal anesthesia.

Conclusion: Spinal anesthesia offers superior postoperative analgesia, better hemodynamic stability, and shorter hospital stay compared to general anesthesia for lower limb surgeries. However, GA remains essential for uncooperative patients, contraindications to neuraxial blocks, and lengthy procedures. Anesthesia should be individualized based on patient condition and surgical requirements.