[Catheter epidural analgesia for treatment of postoperative and post-traumatic pain]

Postoperative epidural local anesthetics or opiates provide excellent analgesia but do not reduce the incidence of respiratory complications compared with systemic analgesics. Additional and sometimes lethal side effects reserve the routine use of epidural analgesia for highly selected patients. Thoracic epidural analgesia (TEA) may prevent ventilation in patients with serial rib fractures (SRF) without gross pulmonary parenchymal lesion. TEA results in fewer pulmonary complications, shorter hospital stay, and lower mortality than artificial respiration. Late global pulmonary tests after TEA for treatment of SRF show normal results within comparable groups without rib fractures.