The article discusses the impact of an intensive, structured clinical trial on reducing the length of stay after abdominal aortic surgery. The study, conducted by Norris et al., aimed to compare the effects of epidural anesthesia and analgesia with other combinations of intraoperative anesthesia and postoperative analgesia. Despite not observing differences between the epidural and nonepidural groups, all study patients experienced a significant reduction in length of stay, from 15 to 7 days. This dramatic reduction could obscure potential clinical differences between groups and limit conclusions on the effects of epidural anesthesia and analgesia. The authors suggest that the intensive clinical trial protocol, including a defined postoperative clinical pathway, may have contributed to the improved outcomes. However, the high probability of a Hawthorne effect, where the mere presence of observation and experimentation can enhance efforts and cooperation, could also be a factor. The article concludes that while the study's findings are notable, they may not fully capture the benefits of epidural anesthesia and analgesia in routine clinical care.The article discusses the impact of an intensive, structured clinical trial on reducing the length of stay after abdominal aortic surgery. The study, conducted by Norris et al., aimed to compare the effects of epidural anesthesia and analgesia with other combinations of intraoperative anesthesia and postoperative analgesia. Despite not observing differences between the epidural and nonepidural groups, all study patients experienced a significant reduction in length of stay, from 15 to 7 days. This dramatic reduction could obscure potential clinical differences between groups and limit conclusions on the effects of epidural anesthesia and analgesia. The authors suggest that the intensive clinical trial protocol, including a defined postoperative clinical pathway, may have contributed to the improved outcomes. However, the high probability of a Hawthorne effect, where the mere presence of observation and experimentation can enhance efforts and cooperation, could also be a factor. The article concludes that while the study's findings are notable, they may not fully capture the benefits of epidural anesthesia and analgesia in routine clinical care.