Neuraxial anaesthesia and its role in enhanced recovery after surgery: a narrative review

Abstract

Intrathecal (spinal), epidural and the combined spinalepidural (CSE) are neuraxial techniques that can be used to provide postoperative analgesia and, in some circumstances, anaesthesia for surgery. They feature in many current enhanced recovery after surgery (ERAS) protocols with a bias towards epidurals for open surgery because it is thought they provide superior opiate-sparing analgesia and reduce the stress response to surgery through blunting sympathetic outflow. Both are key components of the ERAS concept. We aim to provide an evidenced-based overview for the use of neuraxial techniques in major surgery and their use within an ERAS protocol. We present the following article in accordance with the Narrative Review reporting checklist (available at https:// dx.doi.org/10.21037/dmr-21-86). Review Article