Benefits, Risks and Complications of Perioperative Use of Epidural Anesthesia

Use of thoracic epidurals is widespread for intraoperative and postoperativeanalgesia. Thoracic epidural anaesthesia (TEA) reduces sympathetic activityand thereby influences perioperative function of vital organ systems. A resultsof recent studies suggest that TEA decreases postoperative morbidity and mortality.There is better pain control with TEA in a wide range of surgical procedures.Use of TEA is associated with the risk of harm, but also the other methods used tocontrol perioperative pain and stress response carry specific risks. Timely diagnosisand treatment of spinal compression or infection are crucial to ensure patient safetywith TEA. The benefits of TEA outweigh the risks with respect to the perioperativeoutcome and organ protection, if basic guidelines are followed.