Epidural and spinal agents for postoperative analgesia

Epidural and intrathecal opioid administration is generally accepted as one of the most significant advances in pain management. It is widely used to treat intraoperative, postoperative, traumatic, obstetric, chronic, and can cer pain. Newer developments include the use of a combination of local anes thetics and opioids. Meta-analysis of controlled trials has demonstrated im proved pulmonary outcome in patients receiving epidural postoperative analg esia. Respiratory depression continues to be a rare but significant problem . Extensive international experience has shown that patients receiving spin al opioids for postoperative analgesia can be safely nursed on regular ward s, provided that trained personnel and appropriate guidelines are available .