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Cohort studyAnnals of vascular surgery · 2026

Epidural-Based Multimodal Analgesia and Early Postoperative Recovery After Elective Open Abdominal Aortic Aneurysm Repair: A Prospective Observational Cohort Study.

Dragan Milošević, Dragana Lončar Stojiljković, Dragan Rakanović … Lazar Davidović

AnesthesiologyCohort study

Epidural analgesia linked to shorter ventilation after open abdominal aortic aneurysm repair

Epidural-Based Multimodal Analgesia and Early Postoperative Recovery After Elective Open Abdominal Aortic Aneurysm Repair: A Prospective Observational Cohort Study.

Dragan Milošević … Lazar Davidović

Annals of vascular surgery · 2026

Purpose

OBJECTIVE(S): To evaluate whether the addition of epidural analgesia to general anesthesia is associated with improved early postoperative ICU recovery in patients undergoing elective open abdominal aortic aneurysm (abdominal aortic aneurysm) repair.

Methods

Tertiary care university-affiliated vascular surgery center.

n = 30

Results

time spent on a breathing machine after surgery was much shorter with an epidural

1.5hours

GA+EA ventilation time

5hours

GA ventilation time

More results

The primary outcome was early postoperative ICU recovery, assessed by postoperative mechanical ventilation time and ICU length of stay.

Mean intraoperative MAP, heart rate, the proportion of patients with MAP <60 mmHg, and norepinephrine requirement did not differ significantly between groups.

More results

Intraoperative crystalloid administration was lower in the GA+EA group, while colloid use, blood loss, cell-saver volumes, and transfusion requirements were comparable.

“

Conclusion · 1 of 2

This exploratory, hypothesis-generating study found that epidural-based multimodal analgesia was associated with improved early postoperative ICU recovery following open abdominal aortic aneurysm repair, particularly through earlier extubation and shorter ICU stay.

Conclusion · 2 of 2

Integration of neuraxial techniques within multimodal perioperative care pathways may represent a feasible strategy to optimize recovery in high-risk vascular surgery.

Epidural-Based Multimodal Analgesia and Early Postoperative Recovery After Elective Open Abdominal Aortic Aneurysm Repair: A Prospective Observational Cohort Study.

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