In Reply:--We are well aware of the importance of postoperative myocardial ischemia as a risk factor for postoperative myocardial infarction, and await with interest the results of randomized trials of whether postoperative epidural analgesia can reduce the incidence of infarction, especially in comparison with other antiischemic therapies. We stand by our statement that further trials in which researchers compare the effects of general and regional anesthesia on this outcome are unlikely to be useful, for the reasons we discussed in our editorial.

Alan Go, M.D.; Warren Browner, M.D., M.P.H.; General Internal Medicine Section; VA Medical Center, 111A1; San Francisco, California 94121

(Accepted for publication April 18, 1996.)