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Summary
Epidural analgesia is a common technique used to manage acute pain after major surgery and is viewed as the 'gold standard'. When managed effectively, epidural analgesia is known to reduce the risk of adverse outcomes following major surgery. There are two main classes of medications used in epidural analgesia: opioids and local anaesthetics. Both of these drugs are beneficial in reducing or eliminating pain, but are also responsible for the common side effects associated with this method of pain relief. There are also some rare and potentially fatal side effects of epidural therapy. The nurse's role is to assess and monitor patients carefully and report and respond to any concerns.
Keywords
Acute pain, epidural, pain management, regional analgesia These keywords are based on subject headings from the British Nursing Index. All articles are subject to external double-blind peer review and checked for plagiarism using automated software. For author and research article guidelines visit the Nursing Standard home page at www.nursing-standard.co.uk. For related articles visit our online archive and search using the keywords.
EPIDURAL ANALGESIA isone of the most effective forms of pain relief. It can provide total relief from pain and is viewed as the 'gold standard'. However, there are some rare complications associated with epidural therapy, which may have life-threatening consequences for patients. Nurses need to ensure that they have the knowledge and skills to care for patients with epidural infusions. The nurse needs to be able to monitor patients for adverse effects, and to report and respond to any abnormal findings in a timely manner.
Epidural space
Many textbooks provide complicated diagrams of the epidural space that can be difficult to interpret. In its simplest form, the spinal cord can be likened to a sausage with three skins or membranes called meninges. The epidural space lies between the outer membrane and the bony surround of the vertebrae.
The first membrane closest to the cord is called the pia mater, which means 'soft mother' in Greek. The second membrane is called the arachnoid mater, because of its cobweb-like appearance. The third membrane is known as the dura mater, which means 'hard mother' in Greek. The epidural space, which lies outside the dura, is a potential space, containing blood vessels, nerve roots, fat...