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Major conduction blocks utilizing local anesthetics or opiates are
find ing ever increasing applications in daily routine. However,
two serious drawbacks are associated with their use: hypotension
during surgery and the development of tolerance in long-term
epidural analgesia. When opiates are injected epidurally or
intrathecally, numerous side effects such as itching, nausea and
vomiting, or respiratory depression have been reported. The
pathophysiology of complications arising during a major conduction
block and measures to prevent them were discussed by 19 experts at
the 4th International Symposium at DUsseldorf. This volume contains
21 papers presented on three topics: 1. tachyphylaxis in long-term
epidural anesthesia, 2. hypotension due to epidural and spinal
anesthesia, and 3. effects and dangers of epidural and intrathecal
opiates. With regard to the safety of our patients during
anesthesia, current practices of preventing complications were
evaluated, and preliminary guidelines for a more rational approach
toward prevention and treat ment based on a knowledge of
pathophysiologic mechanisms were developed. It is our hope that the
anesthesiologist will profit from the discussion of regional
anesthesia contained in this volume, many aspects of which have
never before been presented in such detail."
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