Epidural analgesia for postoperative orthopaedic pain

It is well known that traditional postoperative pain management techniques often fail to relieve pain in nearly 50% of postoperative patients. The etiology of poor pain management is rooted in the fears of addiction, overmedication, and the time associated with obtaining controlled substances and administering them to patients. Patients being treated with neuroaxial analgesia (epidural and intrathecal drug administration) are appearing more frequently on orthopaedic nursing units. It is therefore imperative that nurses are familiar with the care of patients with epidural catheters. This article discusses the relevant anatomy, physiology, pharmacology, contraindications, and complications associated with neuroaxial analgesia, with special emphasis placed on the orthopaedic patient.