Development of an anesthesiology-based postoperative pain management service

In recent years, two new therapeutic modalities for treatment of postoperative pain have become available: epidural opiate analgesia (EOA) and patient-controlled analgesia (PCA). Several factors have limited the wide-spread use of these techniques: the cost of PCA machines, the time required by anesthesiologists to manage epidural analgesia, fear of respiratory depression with EOA, and lack of structured programs for the provision of PCA and EOA. In this paper, we describe our approach for dealing with these issues so as to extend the advantages of EOA and PCA to greater numbers of postsurgical patients.