I am careful to describe the proposed surgical procedure as well as the expected post-op course in the hospital and after discharge. Pre-emptive analgesia is based on the idea that analgesia initiated before a nociceptive event will be more effective than analgesia commenced afterwards. The effects of pre-emptive analgesia will outlast the pharmacological duration of action of the analgesic used. The intra-thecal morphine diffuses into the systemic circulation slowly, and provides long duration of action. When possible, epidural anesthesia is often the preferred method of anesthesia for several reasons.
Epidural anesthesia limits the anesthetized area to the surgical site.
The risks and side effects of endotracheal intubation are minimized. Patient recovery time may be decreased. Improved analgesia is provided in the postoperative period when an indwelling epidural catheter is utilized for post-op dosing and pain management. There are multiple methods of post-operative pain management available. A pain pump may be utilized with certain procedures to deliver local lidocaine or marcaine to the operative site over a 24-hour period.