Abstract
The use of epidural anesthesia is declining in frequency because errors in administration may lead to accidents, in particular when administered concomitantly with anticoagulant therapies. However, it is also true that epidural anesthesia is an excellent method for pain relief that shows significant advantages in early ambulation of patients and reducing the length of hospital stays without regard to the postoperative management system. We have created postoperative pain relief procedures for the highest risk patients to take advantage of epidural anesthesia. Anticoagulant therapies are started after removing the epidural catheter, and only one type of anticoagulant is used. A process using a checklist for early detection of spinal epidural hematoma has been established so that nurses can promptly report to senior doctors in contingencies, with a certain level of success. Although postoperative pain relief measures depend on the size and organization of a facility, denying epidural anesthesia is not beneficial to either patients or facilities. Attitudes towards the use of anticoagulants may differ among facilities, but it is necessary to adopt appropriate methods to use epidural anesthesia, IV-PCA, and ultrasound-guided peripheral nerve blocks, considering the advantages and disadvantages of these techniques as well as the circumstances of the facility.
