Epidural use in acute care has decreased because
many patients who have total joint replacements
now receive PCA with peripheral nerve catheters
using a local anesthetic. Epidural pain management
is recommended for patients who have thoracic or
large abdominal surgery, and for patients undergoing
major orthopedic surgery. The epidural catheter is
placed just outside the spinal canal in the epidural
space. Once the catheter is placed, a combination of
local anesthetic and an opioid such as fentanyl is
infused using a pump similar to an I.V. PCA. Patientcontrolled
epidural analgesia (PCEA) lets patients