Epidural opioids are now established as a component of intraoperative epidural anaesthesia, improving onset time, quality, and duration of epidural blockade. For postoperative pain, labour pain, and acute post-traumatic pain, epidural opioids alone are being replaced by combinations of low-dose opioid, low-concentration local anaesthetic solution, and sometimes adrenaline or a more specific a2-agonist. Also for chronic cancer pain, such epidural mixtures are now used for otherwise intractable pain. These two- or three-component epidural mixtures reduce side effects of epidural opioids and make epidural analgesia safer on ordinary hospital wards.