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Are epidurals worthwhile in vascular surgery?

Veering, Bernadette T

Current Opinion in Anaesthesiology: October 2008 - Volume 21 - Issue 5 - p 616–618
doi: 10.1097/ACO.0b013e32830c6ec8
Regional anesthesia: Edited by Bernadette Veering

Purpose of review: 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.

Recent findings: 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.

Summary: Optimization of perioperative care rather than the anaesthetic technique may have potential benefit in improving postoperative outcome.

Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands

Correspondence to Bernadette T. Veering, MD, PhD, Department of Anesthesiology, Leiden University Medical Center, P5-Q, P.O. Box 9600, 2300 RC Leiden, The Netherlands Tel: +31 71 52622301; fax: +31 71 5266230; e-mail: B.Th.Veering@lumc.nl

© 2008 Lippincott Williams & Wilkins, Inc.