Epidural Analgesia for Postoperative Pain Relief

Abstract

 Epidural analgesia has long been an important technique for post operative pain relief in this country. However, the indication for or practice of epidural analgesia has recently been changing because new drugs, such as the antiplatelet agent fondaparinux, or the opioid analgesic remifentanil are being used more. Administration of fondaparinux to prevent perioperative pulmonary artery embolism strictly limits the indication of epidural analgesia. Concerning remifentanil, whose analgesic effect rapidly disappears upon its discontinuation, its use can make postoperative pain relief more complicated. Even under remifentanil use, we believe that epidural analgesia can provide pain relief of higher quality. In this article, we review the usefulness of epidural analgesia for postoperative pain relief compared with that of intravenous opioid infusion, and we evaluate three practices of epidural analgesia to obtain higher-quality of postoperative pain relief in patients undergoing general anesthesia with remifentanil.