Epidural and Intravenous Use of Opiates

Fentanyl is often placed in epidural solutions and it's important to realize that the data is fairly clear that an epidural fentanyl infusion does not have any neuroaxial effect. With a PCEA where patients can give themselves a bolus from time to time you may actually get some added Neuroaxial effect from placing epidural fentanyl in there with bupivicane. Hydromorphone probably the most commonly used opiate in the hospital aside from fentanyl maybe is five to ten times as potent as morphine takes 20 minutes to reach peak effect. Meparidine is used most commonly where I've worked at doses of 12.5 to 25 milligrams at a time to treat sh