Neuraxial drug administration is widely used in anesthesiology and pain therapy.

The neuraxial route is characterized by unique pharmacokinetic and pharmacodynamic properties, and many drugs have been introduced to clinical practice.

A solid understanding of the pharmacology of neuraxially administered drugs is indispensable for anesthesiologists and pain practitioners using these techniques in order to safely and efficiently accomplish anesthesia and analgesia.

In the present review we summarize the pharmacology of the most commonly used neuraxial drugs, the clinical indications, possible neurotoxic effects and new developments in neuraxial drug therapy.