Delirium is a distressing syndrome that affects many surgical patients. Postoperative delirium is associated with falls, cognitive and functional decline, and prolonged hospitalization. Indeed, delirium is a major public health issue, and postoperative delirium serves as a target for surgical quality improvement. A promising strategy for reducing risk involves sustained interventions that simultaneously target multiple risk factors. Epidural analgesia is one such candidate intervention that has been demonstrated to reduce key delirium risk factors: pain, opioid consumption, and inflammation.4–6  Furthermore, epidural therapy can be continued over multiple days, particularly during time windows of peak delirium risk. Taken together, it seems plausible that such a sustained intervention, which simultaneously targets multiple risk factors, could reduce risk of postoperative delirium.

As reported in this issue of Anesthesiology, Li et al. sought to determine whether combined...

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