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5.6 Epidural analgesiaEpidural analgesia provides excellent pain management after major surgery. It is only safeto use on wards with trained staff under pain service supervision. Usually, a combinedlocal anesthetic and opiate infusion is used. These drugs act synergistically, but can begiven separately. The level and density of block must be regularly assessed. Ideally, thelocal anesthetic will provide blockade of small nerve fibers (pain and temperature) butmaintain fine sensation and motor power. The opiates augment the analgesic effect atspinal level.
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