Neuraxial analgesia: epidural and spinal drugs

  • N. Rawal
Part of the Topics in Anaesthesia and Critical Care book series (TIACC)


Recent research has demonstrated the increasing importance of the spinal cord in processing and modulating nociceptive input. Since their introduction into clinical practice in 1979 spinal opioids have achieved great international popularity in a variety of clinical settings either as sole analgesic agents or in combination with low-dose local anaesthetic. By bypassing the blood and blood brain barrier, small doses of opioids administered in either the subarachnoid or epidural spaces provide profound and prolonged segmental analgesia. This undoubtedly represents a major breakthrough in pain management. Numerous studies have shown that spinal opioids can provide profound postoperative analgesia with fewer central and systemic adverse effects than opioids administered systemically. A large number of non-opioids have also been administered in the epidural or subarachnoid space to achieve pain relief without the risk of respiratory depression.


Respiratory Depression Epidural Analgesia Epidural Morphine Labour Pain Patient Control Epidural Analgesia 
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© Springer Verlag Italia, Milano 1999

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  • N. Rawal

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