Principles & Practice of Pain Medicine > Part V. Pain Syndromes > B. Acute and Perioperative Pain > Chapter 42. Acute Pain Management in Adults Christine G. Peeters-Asdourian and Vimal K. Akhouri

Neuraxial Opioids and Local Anesthetics

"These agents can be provided by the epidural or intrathecal route. Of these, the epidural catheter infusion is the most commonly used method and, recently, a cumulative meta-analysis of various postoperative therapies shows that epidural opioids and epidural local anesthetics with or without opioids decreased the incidence of pulmonary complications as opposed to systemic opioids. Epidural analgesia is also associated with a lower incidence of cardiovascular events and provides a decreased stress response to surgery, earlier ambulation, rapid return of bowel function, shortened hospitalization, reduced costs and, overall, a lower mortality...."