Abstract
Epidural administration of opioids and local anesthetics has become the mainstay of acute pain management. However, it has been identified that a single method of pain management may not be adequate for all patients. Because regional analgesia rarely works alone, current practice in pain management is evolving to include multimodal analgesia, combining techniques such as epidural, patient-controlled analgesia, and regional blocks with adjuvant pharmacological therapies such as acetaminophen and nonsteroidal anti-inflammatory agents. As methods of pain management evolve, it becomes important for pharmacists and health care practitioners to understand the issues regarding regional anesthesia and acute pain management. The pharmacist's role in the Acute Pain Management Service (APMS) may include reviewing patient's drug therapy, optimizing drug selection, and developing policies and procedures. Pharmacists also supervise and evaluate intraspinal (epidural and intrathecal) solution preparation, stability, storage, and safety issues. The pharmacist's role in the APMS and pharmacy considerations regarding the preparation and distribution of regional anesthetic agents will be reviewed. Current standards of practice at Thomas Jefferson University Hospital will be discussed. Copyright 2002, Elsevier Science (USA). All rights reserved.
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