As competition for health care funds becomes progressively more intense, it is imperative for anesthesiologists to objectively examine the current understanding of whether certain types of anesthetic techniques such as epidural anesthesia and analgesia in high-risk patients undergoing lower extremity revascularization can reduce the incidence of postoperative morbidity, which prolongs ICU stay as well as hospitalization or otherwise increase both direct and indirect costs. Though it is possible and even likely that other perioperative interventions unrelated to choice of anesthetic can also positively impact outcome after lower extremity revascularization, the outcome studies to date have generated solid basis for epidural techniques as the preferential choice for anesthesia and analgesia in these patients. Epidural anesthesia is not a magic bullet, but it is clearly the anesthetic technique with the greatest potential for reducing morbidity after lower extremity revascularization.
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