Continuing Education in Anaesthesia Critical Care and Pain | Volume 4 Number 2 | 2004
© The Board of Management and Trustees of the British Journal of Anaesthesia 2004
Benefit and outcome after epidural analgesia
Western General Hospital, Crewe Road, Edinburgh, EH4 2XU
Tel: 0131 537 1652, Fax: 0131 537 1025, E-mail: susan.nimmo{at}luht.scot.nhs.uk
Epidural analgesia is considered by many as the gold standard analgesic technique for major surgery. It has the potential to provide suitable patients with complete analgesia for as long as the epidural is continued. This is usually achieved with a combination of epidural local anaesthetic and an opioid. Epidural techniques are particularly effective at providing dynamic analgesia, allowing the patient to mobilize and resume normal activities unlimited by pain. Parenteral opioids, even with patient-controlled delivery systems, cannot predictably provide the same quality of analgesia. In particular, pain on movement (dynamic analgesia) is generally less well controlled.
One of the major issues of concern to patients presenting for major surgery is analgesia, and an epidural technique can be recommended on these grounds alone. However, the benefits of epidural anaesthesia and analgesia are not limited to pain relief, and this article will discuss the benefits and potential complications of epidural analgesia in high-risk patients presenting for major surgery.