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Epidural route

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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

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