Epidural Analgesia
Mrs Grace Crawhall discussing her epidural pain control with the Lismore Base Hospital CNS Acute Pain Stephanie Pagotto and Anaesthetic Registrar Rosslyn Thistlethwaite
What is epidural analgesia?
Before surgery and after discussion with you, your anaesthetist may decide to insert a tiny tube into an area near your backbone called the epidural space. This tube is called an epidural catheter.
The control of pain that occurs when special medication is injected into the epidural catheter is called epidural analgesia.
There are two types of medication commonly injected into the epidural space for the purpose of epidural analgesia :
- Local anaesthetic - this medication numbs the nerves that carry pain signals from the wound/injury
- Opioid – this medication also called a ‘narcotic’ decreases pain signals to the brain.
These medications may be given as a single injection or may run continuously into the epidural space. The medications may be used separately or together. Whichever way, epidural analgesia usually provides excellent pain control.
Is epidural analgesia safe?
Epidural analgesia is widely used and has a very good safety record. If you have an epidural for pain control you will be visited daily by the Acute Pain Service/team to ensure your comfort and safety.
All procedures do have risks. There may be tenderness where the catheter goes into your back. Occasionally patients experience headache. The risk of serious complications such as difficulty in breathing, nerve damage or infection is rare.
The nursing staff are trained to care for patients with epidural catheters, and will observe you closely.
If you have any questions or worries about epidural analgesia please tell the nurse or doctor.
What if I become uncomfortable?
Occasionally epidural analgesia does not work as well as we would like. If this happens you may become uncomfortable in some way. Here are some of the things that may make you uncomfortable and may indicate your epidural is not working as it should:
- part/all of your body gets itchy
- severe nausea or lightheadness
- severe weakness/numbness develops
- pain when lying still
- pain when coughing or moving
- difficulty in passing urine
- severe headache
If you are bothered by any of these effects please tell your doctor or nurse. These effects may be treated by adjusting the amount of medication in the epidural, or by giving other medications or fluids.
What can I do to get the best results from an epidural?
Help the doctors and nurses to ‘measure’ your pain. You will be asked to score your pain on a scale from zero to ten with zero being no pain and ten being the worst pain imaginable.
- tell your nurse if your pain is not well controlled
- tell your nurse if your legs feel heavy or weak
- do not try to get out of bed or walk around without the help of a nurse or physiotherapist
- remember to do the deep breathing and leg exercises as instructed. You will be given oxygen enriched air through a mask or nasal prongs ensure you keep this in place.
- simple relaxation may be helpful, try slow deep breathing.
How long will the epidural stay in?
The average is 2-4 days. If needed, you will be given other medications to control your pain when the epidural is removed. Removal of the epidural catheter causes no discomfort.