Is Epidural anesthesia most effective in pain control?
Some research states that epidural pain relief is best, Malle´dant et al., states that ‘Epidural anesthesia, which by far would be most effective in pain control, seems to beneficially influence the course of the disease by improving pancreatic microcirculation and tissue oxygenation. Epidural analgesia can be considered for those patients with severe and critical acute pancreatitis who require high doses of opioid’s for an extended period. Although it has been reported that analgesics could also be given transdermally or rectally. Although pain is probably secondary to multifactorial pathogenetic mechanisms, it has been considered that the action of pancreatic enzymes and endogenous inflammatory mediators can stimulate visceral pancreatic or somatic peritoneal pain receptors. Patients with severe pain will require intravenous analgesia and for some patients a patient-controlled analgesia (PCA), should be considered. However, there are issues that can arise from using a patient-controlled analgesia. It is not suitable for all patients, such as those with impaired conscious levels, learning difficulties, confusion, memory problems or renal abnormalities.