Benefit and outcome after epidural analgesia

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 highrisk patients presenting for major surgery. Potential benefits of epidural analgesia