Epidural anesthesia has been used frequently in labor and delivery since at least the 1970's. Over the last number of years it has been increasingly offered to many undergoing a variety of other operations as well.
I had a total hip replacement under general anesthesia in 1997 and had severe post operative pain.
I had a revision total hip replacement last week with epidural anesthesia (that was kept in place for 48 hours post operatively) and had virtually no pain during the immediate post operative period.
The only draw back was the need to have a urinary catheter inserted-also a first for me. This was discontinued just prior to stopping the epidural.
But in terms of a decision tree it relatively simple: Severe pain is not good. No pain is good.
There are also many reports that the elderly, in particular, do much better from a cognitive standpoint with an epidural versus general anesthesia.
If it's an option, take the epidural!