Delirium is a common and serious postoperative complication, especially in the elderly. Epidural anesthesia may reduce delirium by improving analgesia, reducing opioid consumption, and blunting stress response to surgery. In this issue of Anesthesiology, Li et al. tested the hypothesis that combined epidural–general anesthesia can reduce the incidence of postoperative delirium in elderly patients recovering from major noncardiac surgery. In an accompanying editorial, Vlisides and Mashour discuss the strengths and limitations of this new study and the implications for practicing anesthesiologists. Cover Illustration: A. Johnson, Vivo Visuals.

  • Li et al.: Delirium in Older Patients after Combined Epidural–General Anesthesia or General Anesthesia for Major Surgery: A Randomized Trial, p. 218

  • Vlisides and Mashour: The Cognitive Neuraxis: Epidurals and Postoperative Delirium, p. 197