Postoperative epidural analgesia

Epidural analgesia offers patients a state close to ‘no pain' following surgery. The pharmacology of epidural opioids, local anaesthetics, combination therapy and newer agents is discussed. Combination local anaesthetic-opioid solutions provide superior analgesia to other techniques. Patients for epidural management can be selected based on surgical procedure and concurrent illness. A conservative approach is recommended and practical issues of implementing epidural management in postoperative surgical wards is discussed.