Patients undergoing surgery need good advice not only about whether a particular elective procedure is truly necessary and likely to be of benefit, but also about the nature and chances of an adverse outcome from the surgery itself. Those with heart failure, coronary artery disease, diabetes or emphysema are more likely to suffer serious complications or death after major surgery. Epidural anaesthesia and analgesia may be a preferable technique in such patients,1 as epidural block can attenuate the neurohumoral stress response to surgery,2 potentially improving postoperative cardiorespiratory function and reducing complications.
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