Over the past decade, awareness of the harmful effects of postoperative pain has increased. These effects seem to be intensified in critically ill patients. Epidural analgesia has been shown to improve pulmonary function in the critically ill, including a reduction in frequency of intubation and tracheostomies and decreased length of mechanical ventilatory support. In addition, the heightened metabolic-stress response associated with pain may be averted, thereby reducing problems with fluid retention that may further compromise pulmonary status. As a result, epidural analgesia can lead to: shortened length of stay in the ICU overall decreased mortality rate improvement in quality of life As a pain-control method, epidural analgesia is gaining popularity in a variety of ICU patient populations. Therefore, critical care nurses need to update their knowledge base and nursing practice to provide safe and effective nursing care. State nurse practice acts and agency policies dictate the amount and type of involvement nurses have in caring for patients receiving epidural pain therapy. Potential life-threatening problems with epidural analgesia are rare. Many side effects can be controlled or prevented with appropriate patient selection and nursing management.

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