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Epidural anesthesia is commonly called an “epidural.” It is anesthesia that is injected into the epidural space in the spine. The epidural space is between the wall of the spinal canal and the covering of the spinal cord.
An anesthesiologist uses a thin needle to place a small tube called an epidural catheter. An anesthesiologist is a doctor who manages pain.
The needle is removed, leaving the catheter in place. It is about the size of a fishing line.
The other end of the catheter connects to a pump. The pump gives pain medicine. The medicine blocks pain messages sent by the nerves to the brain.
Epidural medicines can control pain without making your child too sleepy. Pain medicines given as a pill or through an intravenous (IV) line can make your child feel sleepy. That is because some of the drug goes to the brain. When medicines are directed to pain nerves, less drug goes to the brain.
The goal of an epidural is to reduce or prevent pain so your child can breathe deeply, get out of bed, and sleep in comfort. When patients are more alert, they can know right away if they need more pain medicine. This allows ease in turning, coughing, sitting up, or walking after surgery. These movements help your child recover from surgery.
No, most children cannot feel the catheter or the medicines.
Providers give 2 types of medicines in the epidural catheter. Your child will likely have both types:
Yes. The anesthesiologist decides how much pain medicine your child needs based on your child’s age, body size, type of surgery, and overall medical condition. The doctor can adjust the amount of pain medicine your child receives as needed.
Any medicine used to manage pain can cause side effects.
The most common side effects are:
Other side effects relate to the catheter rather than the medicines. These rare side effects include infection, bleeding, and headache. The care team will watch your child for early signs of these problems. There are treatments for side effects.
Yes. This is breakthrough pain. If your child is old enough, the care team will ask them to use a pain scale to describe the level of pain.
One goal of giving pain medicine this way is to allow children to move their legs. Your child may get out of bed with help if the care team says it is OK. Please call a nurse or physical therapist the first time your child gets out of bed.
You should call your child’s nurse if:
Your care team will assess:
At times, the care team will ask your child to move their legs. This is important to make sure the medicines and catheter are not causing any serious side effects.
The epidural catheter will have a clear dressing over it. You will not need to change the dressing. If the edges become loose or the other tape becomes loose, please tell your child’s nurse.
Every type of pain relief medicine has risks. These risks include:
If you have questions or concerns about the epidural, please talk to your child’s doctor or anesthesiologist.
There is a small risk that the needle used to place the epidural catheter can enter the spinal space instead of the epidural space. If this occurs, your child may have a headache for a few days. There is a very low risk of infection or bleeding around the tube. But in some rare cases it can cause nerve damage.
Most often, the epidural catheter will remain in place for 2-5 days. At that point, your child can take other pain medicines by mouth or IV.
Taking the catheter out of the back is fairly painless. The nurse will use adhesive remover to make the tape come off easier. After the catheter is removed, the nurse will place a self-stick bandage on the site. The bandage needs to stay in place for 1 day.
Reviewed: February 2022