epidural route
Last reviewed 01/2018
Epidural analgesia is commonly used for surgery and has the following advantages:
- extended effect of drug
- intense, appropriate analgesia
- less clouding of consciousness; surgical regional anaesthesia without general anaesthesia
- can be combined with local analgesic and deep vein thrombosis prophylaxis
Disadvantages of the epidural route include:
- technical skills are required to place the line
- nurses need training in looking after the line and handle complications
- side effects are common, e.g. urinary retention
- importantly, there can be late respiratory depression and so adequate monitoring is essential during this period
- relatively expensive compared to other forms of analgesia
Common epidural analgesics include opioids such as fentanyl and local anaesthetics such as bupivacaine.
With local anaesthetics, the following complications can occur:
- hypotension
- toxicity due to inadvertent intravenous administration