Epidural analgesia in the dog and cat

A brief outline of the history of epidural analgesia is followed by a review of the anatomy of the epidural space with particular reference to epidural block. The technique of epidural injection in the dog is described as are the indications for the technique. These include the provision of anaesthesia for such procedures as orthopaedic surgery of the hind limb and caesarian section. The cardiovascular effects of epidural block are discussed and suggestions are made for the prevention of hypotension. The various drugs and their combinations which may be used for epidural administration are outlined. The commonest used local anaesthetic agents are bupivacaine and lidocaine. Epidural administration of opioid drugs is a relatively new technique which is used to provide intra- and post-operative analgesia. Morphine is the drug of choice for this indication. The use of other classes of drugs, such as the alpha 2 agonists and ketamine, are also considered. A variety of side-effects, contra-indications and complications are described together with methods for reducing their incidence and effects.