Epidural analgesia for postoperative pain

Epidural analgesia is an important analgesic option in the control of postoperative pain. The analgesic and physiologic benefits conferred by epidural analgesia may potentially result in an improvement in many outcomes including reduced morbidity (eg, coagulation, cardiovascular, pulmonary, and gastrointestinal) and improved patient-oriented endpoints, although there are several methodology issues that confound the findings. "Epidural analgesia" should not be used as a generic technique because multiple factors (eg, catheter-incision congruent analgesia, duration of use, and analgesic regimen) may influence the efficacy of this technique on patient outcomes, especially in the high-risk patient population. The use of postoperative epidural analgesia as part of a multimodal approach may result in early patient convalescence and improvement in outcomes. Despite the benefits of perioperative epidural analgesia, there are risks (some of which can be devastating) associated with use of epidural analgesia, and clinicians should weigh the risks and benefits of epidural analgesia for each patient on an individual basis.