Are epidurals worthwhile in vascular surgery?
OBJECTIVE
Patients undergoing major vascular surgery are at increased risk for postoperative complications due to the high incidence of comorbidities in this population.Epidural anaesthesia provides potential benefits but its effect on morbidity and mortality is unclear.


RESULTS
Existing studies fail to demonstrate improved clinical outcome and reduced mortality for epidural anaesthesia or combined epidural/general techniques compared with general anaesthesia. Postoperative epidural analgesia provides better pain relief and reduces the duration of postoperative mechanical ventilation.


CONCLUSIONS
Optimization of perioperative care rather than the anaesthetic technique may have potential benefit in improving postoperative outcome.
Veering
Bernadette T
BT
Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands. B.Th.Veering@lumc.nl
D000767:Anesthesia, Epidural / Q000401:mortality*; D006801:Humans; D019990:Perioperative Care; D011183:Postoperative Complications / Q000401:mortality*; D012307:Risk Factors; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality*