Abstract

Effective postoperative pain relief continues to be a major problem. At present, the three methods commonly employed—systemic analgesics, local anesthetics, and epidural or intrathecal opiates—have some drawbacks. Systemic analgesics are simple to administer and require minimal physician participation; however, the analgesia obtained is frequently inadequate due to improper dosage or improper dosage schedule. Epidural local anesthetics offer the most complete degree of analgesia; but frequent injections are required, and side effects such as hypotension are possible. Epidural opiates provide long periods of pain relief; but delayed respiratory depression, pruritus, and urinary retention may occur.