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Invited Commentary
September 07, 2016

Increased Survival Secondary to Decreased Perioperative Complications in Open Aortic Aneurysm Repair Using Epidural Anesthesia The Long and the Short of It

Author Affiliations
  • 1Veterans Administration Puget Sound Health Care System, University of Washington, Seattle
  • 2Division of Vascular Surgery, Department of Surgery, University of Washington, Seattle
JAMA Surg. Published online September 7, 2016. doi:10.1001/jamasurg.2016.2753

Epidural analgesia is widely recognized to be a very effective method of postoperative pain control. Various benefits in terms of postoperative recovery after both major abdominal procedures and open abdominal aortic aneurysm repair have been attributed to the use of postoperative epidural analgesia.1 In the study by Bardia et al2 in this issue of JAMA Surgery, the authors focus instead on the effect of intraoperative adjunctive epidural anesthesia (EA) use by analyzing the Vascular Study Group of New England data registry for patients undergoing elective, open abdominal aortic aneurysm repair. They demonstrated a decrease in postoperative bowel ischemia, need for dialysis, respiratory complications, and short-term reoperation in the EA-general anesthesia (GA) group from the GA-alone group, which translated into a decrease in long-term mortality at 5 years by Kaplan-Meier survival analysis.

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