Show Summary Details
Page of

Neuraxial Analgesia and Anesthesia in Chronic Opioid Users and Patients with Pre-existing Pain 

Neuraxial Analgesia and Anesthesia in Chronic Opioid Users and Patients with Pre-existing Pain
Chapter:
Neuraxial Analgesia and Anesthesia in Chronic Opioid Users and Patients with Pre-existing Pain
Author(s):

Grace Chen

and Ashley Valentine

DOI:
10.1093/med/9780190457006.003.0007
Page of

PRINTED FROM OXFORD MEDICINE ONLINE (www.oxfordmedicine.com). © Oxford University Press, 2020. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 01 December 2020

Neuraxial anesthesia and analgesia are effective modalities for surgery and perioperative pain management, respectively. These techniques may have nonanalgesic benefits as well, including improved 30-day mortality benefit, decreased risk of perioperative pneumonia, decreased risk of persistent postoperative pain, and attenuation of the stress response to surgery with improved survival in certain cancers. Post-operative pain control with epidural can be especially beneficial for opioid tolerant chronic pain patients compared to enteral or parenteral analgesics alone. In patients with previous back surgery or scoliosis, neuraxial techniques may be technically difficult. However, there is no evidence to suggest neuraxial approaches worsen pre-existing back pain. The exceptions are a pathology that reduces spinal canal cross-sectional area (e.g., severe spinal stenosis) and spinal infection. Neuraxial techniques should be avoided in these patients. Preprocedural labs and imaging are dictated by patient comorbidities, medication, and anatomy (e.g. scoliosis or spinal column pathology).

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.