Neuraxial (spinal and epidural) blocks for acute pain management

Neuraxial (spinal and epidural) blocks provide bilateral analgesia or anaesthesia by administering local anaesthetic into the spinal or epidural space. Epidural blocks are an effective analgesic technique during labour and for acute postoperative pain in some patients. Neuraxial blocks may be performed at the time of surgery to provide anaesthesia; however, this is beyond the scope of this guideline.

Proprietary combinations of local anaesthetics and opioids for neuraxial block are available. Standardising solutions reduces the incidence of dosing errors.

Neuraxial blocks must only be performed by practitioners experienced in their use. Prescribing or altering dose regimens for the maintenance of analgesia is also reserved to practitioners experienced in their use.