CNS Drugs

, Volume 10, Issue 2, pp 91–104 | Cite as

Epidural Analgesics

How Can Safety and Efficacy be Improved?
  • Pierre Albaladejo
  • Hervé Bouaziz
  • Dan Benhamou
Disease Management

Abstract

Numerous studies have shown that epidural anaesthesia/analgesia is a powerful analgesic technique, but one which has a low therapeutic index. Although traditionally based on the use of local anaesthetics, epidural analgesia is now being performed using combinations of local anaesthetics and opioids with the aim of improving the quality of analgesia and reducing adverse effects. In recent years, there have been major advances in the evaluation of minimum effective doses and concentrations for local anaesthetics and opioids; this has obvious implications when considering safety in anaesthetic techniques, especially in the relief of labour pain or postoperative incisional pain. Moreover, by implementing monitoring rules and analgesic protocols, the development of acute pain services has facilitated the use of epidural anaesthesia/analgesia and improved the therapeutic index of this technique.

Keywords

Morphine Fentanyl Adis International Limited Bupivacaine Respiratory Depression 

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Copyright information

© Adis International Limited 1998

Authors and Affiliations

  • Pierre Albaladejo
    • 1
  • Hervé Bouaziz
    • 2
  • Dan Benhamou
    • 2
  1. 1.Department of AnaesthesiologyHôpital BicêtreLe Kremlin-BicêtreFrance
  2. 2.Department of AnaesthesiologyHôpital Antoine-BéclèreClamartFrance

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