Physiology and pharmacology of spinal and epidural anaesthesia
O'Donohoe PB., Pandit JJ.
Delivering drugs into the spinal and epidural spaces are frequently used techniques in modern anaesthesia. Historically, they carried significant morbidity and fell out of favour. Their safety profile has improved and now they have been shown to convey a safety benefit for patients and often form part of 'enhanced recovery' programmes. With over 300,000 blocks performed, it is important for surgeons to be aware of the postoperative sequelae when patients return to the ward. With subtle differences between spinal and epidural anaesthesia and a wide variety of drugs and doses used, here we review the physiological consequences of neuraxial blocks and the pertinent pharmacology. © 2012 Elsevier Ltd. All rights reserved.