BACKGROUND: Improvement in @entity1 outcome and reduced use of medical resources may result from using epidural anesthesia and @entity1337 as compared with general anesthesia and intravenous opioids, although the relative importance of intraoperative versus postoperative technique has not been studied. This prospective, double-masked, randomized clinical trial was designed to compare alternate combinations of intraoperative anesthesia and @entity86 with respect to postoperative outcomes in @entity1 undergoing surgery of the abdominal aorta. METHODS: One hundred sixty-eight @entity1 undergoing surgery of the abdominal aorta were randomly assigned to receive either thoracic epidural anesthesia combined with a light general anesthesia or general anesthesia alone intraoperatively and either intravenous or epidural @entity1 -controlled @entity1337 postoperatively (four treatment groups). @entity1 -controlled @entity1337 was continued for at least 72 h. Protocols were used to standardize perioperative medical management and to preserve masking intraoperatively and postoperatively. A uniform surveillance strategy was used for the identification of prospectively defined @entity260 . Outcome evaluation included postoperative hospital length of stay, direct medical costs, selected postoperative morbidities, and postoperative recovery milestones. RESULTS: Length of stay and direct medical costs for @entity1 surviving to discharge were similar among the four treatment groups. Postoperative outcomes were similar among the four treatment groups with respect to @entity204 , @entity583 , @entity741 , reoperation, @entity55 , and @entity177 . Epidural @entity1 -controlled @entity1337 was associated with a significantly shorter time to extubation (P = 0.002). Times to intensive care unit discharge, ward admission, first bowel sounds, first flatus, tolerating clear liquids, tolerating regular diet, and independent ambulation were similar among the four treatment groups. @entity282 scores were also similar among the four treatment groups. CONCLUSIONS: In @entity1 undergoing surgery of the abdominal aorta, thoracic epidural anesthesia combined with a light general anesthesia and followed by either intravenous or epidural @entity1 -controlled @entity1337 , offers no major advantage or disadvantage when compared with general anesthesia alone followed by either intravenous or epidural @entity1 -controlled @entity1337 .

Double-masked randomized trial comparing alternate combinations of intraoperative anesthesia and XXXX in abdominal aortic surgery.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'Patient'] @entity55 :: ('MESH:D011014', 'Disease') :: ['pneumonia'] @entity1337 :: ('MESH:D000699', 'Disease') :: ['analgesia'] @entity260 :: ('MESH:D011183', 'Disease') :: ['postoperative complications'] @entity177 :: ('MESH:D051437', 'Disease') :: ['renal failure'] @entity86 :: ('MESH:D019106', 'Disease') :: ['postoperative analgesia'] @entity741 :: ('MESH:D017202', 'Disease') :: ['myocardial ischemia'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity282 :: ('MESH:D010149', 'Disease') :: ['Postoperative pain']
@entity86 :: (MESH:D019106,Disease) :: ['postoperative analgesia']
