Anesthesiology 2002; 97:1025-1029 A clinical trial by Norris et al. examined the impact of epidural anesthesia and analgesia on outcomes after abdominal aortic surgery. The study found no differences between epidural and non-epidural groups, but all patients experienced a significant reduction in hospital stay (from 13 to 7 days). This reduction may have obscured potential differences between groups, limiting conclusions about the effects of epidural anesthesia. Factors such as a defined clinical pathway and the Hawthorne effect (increased effort due to being in a trial) may have contributed to the reduced hospital stay. The study's conclusions may be overstated due to these factors. Other researchers argue that epidural analgesia can improve postoperative outcomes, including reduced pain, faster recovery, and lower mortality. However, the Norris study's findings may be influenced by the trial's design, including the use of a clinical pathway and the Hawthorne effect. The study's conclusions that epidural anesthesia offers no major advantage or disadvantage may not be valid due to these factors. The study's use of length of stay as the primary outcome may be insufficient, as it is affected by many factors. Other studies have shown that epidural analgesia can improve postoperative outcomes, including reduced hypercoagulability, faster return of bowel function, and decreased pulmonary complications. The study's use of opioids in all patients may have obscured the potential benefits of epidural analgesia. The study's conclusions may be overstated due to the trial's design, including the use of a clinical pathway and the Hawthorne effect. The study's findings may not be generalizable to routine clinical care. The study's use of length of stay as the primary outcome may be insufficient, as it is affected by many factors. Other studies have shown that epidural analgesia can improve postoperative outcomes, including reduced pain, faster recovery, and lower mortality. The study's use of opioids in all patients may have obscured the potential benefits of epidural analgesia.Anesthesiology 2002; 97:1025-1029 A clinical trial by Norris et al. examined the impact of epidural anesthesia and analgesia on outcomes after abdominal aortic surgery. The study found no differences between epidural and non-epidural groups, but all patients experienced a significant reduction in hospital stay (from 13 to 7 days). This reduction may have obscured potential differences between groups, limiting conclusions about the effects of epidural anesthesia. Factors such as a defined clinical pathway and the Hawthorne effect (increased effort due to being in a trial) may have contributed to the reduced hospital stay. The study's conclusions may be overstated due to these factors. Other researchers argue that epidural analgesia can improve postoperative outcomes, including reduced pain, faster recovery, and lower mortality. However, the Norris study's findings may be influenced by the trial's design, including the use of a clinical pathway and the Hawthorne effect. The study's conclusions that epidural anesthesia offers no major advantage or disadvantage may not be valid due to these factors. The study's use of length of stay as the primary outcome may be insufficient, as it is affected by many factors. Other studies have shown that epidural analgesia can improve postoperative outcomes, including reduced hypercoagulability, faster return of bowel function, and decreased pulmonary complications. The study's use of opioids in all patients may have obscured the potential benefits of epidural analgesia. The study's conclusions may be overstated due to the trial's design, including the use of a clinical pathway and the Hawthorne effect. The study's findings may not be generalizable to routine clinical care. The study's use of length of stay as the primary outcome may be insufficient, as it is affected by many factors. Other studies have shown that epidural analgesia can improve postoperative outcomes, including reduced pain, faster recovery, and lower mortality. The study's use of opioids in all patients may have obscured the potential benefits of epidural analgesia.