What is Epidural Analgesia?
Epidural Analgesia is one way of giving pain relief after surgery. Medication is given through a thin tube called a catheter that is put into your child’s skin near the backbone. The thin tube is put in by an anesthesiologist before the operation, after your child is asleep or sedated. It is threaded into the epidural space, a small space around the spinal cord, and then taped in place with a clear dressing. After surgery, the catheter will be used to give your child pain and numbing medications.
How does it work?
The medicine blocks the pain messages that are being sent from the nerves to the brain. The medication is given around-the-clock through a pump to provide steady pain control for your child. Epidural medications are given close to the location of surgery, which allows for smaller amounts of medicine to be used right where it is needed. Please know that we cannot take away all of your child’s discomfort. Your child will be watched closely by surgeons, anesthesiologists and nurses to make sure that he/she is as comfortable as possible during their recovery.
Some children may also have Epidural PCA (patient controlled analgesia).
Is Epidural PCA safe?
PCA allows your child to get more medicine when they need it by pushing a special button on the pump. Epidural PCA is very safe if the button is pushed only when your child needs pain medication. You should not push the button for your child when he/she is sleeping or resting comfortably. Doing this could overdose your child and cause him/her to have difficulty breathing. The pump will only give the amount of medicine your doctor has ordered and only as often as ordered. The amount that is ordered is based on a patient pushing the button when he/she is in pain. That is why it is important that you as a parent or caregiver do not push the button when your child is not in pain.
If the button is pushed more often than the timer allows, the dose of medicine will not be given again until enough time has passed.
Does it hurt to get medicine through an epidural catheter?
No! Most children cannot feel the catheter or the medicine at all. Your child may have a numb or heavy feeling in the legs or stomach, but should still be able to move his legs/toes.
What are the side effects?
Side effects are possible when any medicine is given. Because smaller doses of medication are needed with epidural medication than intravenous (IV), side effects are usually limited. The most common side effects are itching, nausea or vomiting. These are usually mild and other medicines can be used to treat these problems.
Other side effects include tingling in the legs, difficulty with passing urine, drowsiness, or sleepiness, and breathing that is slower than usual. Nurses will be checking your child’s temperature, blood pressure, pulse, and breathing rate frequently. A tube for draining urine from the bladder may be used while the epidural catheter is in place.
Other possible side effects have to do with the catheter rather than the medicine. These are infection, bleeding and headache, but they occur very rarely.
How long will the catheter be in?
The catheter is usually left in for 2-5 days, depending on the type of surgery and how your child is recovering. An anesthesiologist or pain management specialist will remove the catheter when it is no longer needed. Your child will feel the tape coming off—but not the catheter itself being removed. After the catheter is removed pain medicines will be given by mouth or through an IV so that your child will continue to be comfortable.
This information is not intended to substitute or replace the professional medical advice you receive from your child's physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease. Please consult your child's physician with any questions or concerns you may have regarding a medical condition.