Your doctor or anaesthetist
may have talked about epidural analgesia for your child's pain
management after surgery. Epidurals are commonly used as pain management for women
giving birth.
Epidurals are also used for
babies, infants and children after surgery to help them recover faster by providing very good pain relief. The Royal
Children's Hospital has been using epidural analgesia for many
years to provide pain relief after some surgery involving the
chest, abdomen or lower limbs.
Complications are rare and
these will be discussed with you by the
anaesthetist. The risk will be weighed up against the benefit
of having an epidural. The Children's Pain Management Service staff
will manage the epidural and your child's pain.
What is an epidural?
A special needle is placed
between the bones of the back (the vertebrae) and a piece of fine
tubing called a catheter is placed in the epidural
space.
The anaesthetist will put
the epidural catheter in your child's back once they are asleep
under the general anaesthetic. The catheter is then taped securely
to your child's skin so they cannot pull it
out.
Local anaesthetic is given
through the catheter by a special pump. The local anaesthetic numbs
the nerves which stops the sensation of pain over the operation
area.
Why have an
epidural?
Epidurals can provide good
pain relief because they can stop your child feeling pain in the
area where they have had surgery, without the side effects that some
other pain medicines have.
Epidurals are mainly used
for hip and leg operations and some abdominal (tummy) and chest
operations.
What should my child expect?
Most children feel numb
over the operation area and sometimes describe the feeling as
'fizzy' or 'tingly'. They may have less strength in their legs,
which may feel heavy. Most children don't find this sensation
worrying.
Your child should be comfortable enough to
move or cough. If your child has an epidural for surgery below the
belly button, it is likely they will require a urinary catheter
which drains the urine from the bladder, just while the epidural is
in place.
The Children's Pain Management Service (CPMS)
staff will visit your child twice a day and make sure the
epidural is working well. If it is not working well, the
epidural infusion can be altered and other pain medicines may also
be given.
The epidural is usually
removed after three to four days and the removal is not painful or distressing.
After the epidural is turned off, the 'fizzy' and heavy feelings wear off and normal feeling returns after about four hours. CPMS staff will make sure your child has other pain medicine ordered for when
the epidural is stopped.
At home care
Your child will be given
regular pain medicine by mouth after the epidural has been removed
and may need pain medicine for a few days after going
home.
You will receive an
epidural discharge information sheet before you go home.
If your child needs strong
pain medicine at home the CPMS nurse will
contact you by phone to help you manage your child's
pain.
Key points to remember
- Epidurals provide good pain
relief.
- Epidurals are used for pain relief after major surgery.
- The epidural is removed after three to four days.
- Other pain medicine may be given to
your child.
- Your child will have their pain/comfort
assessed regularly.
- The Children's Pain Management Service will
see your child every day.
Contact and more information
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Developed by the RCH Dept of Anaesthesia
and Pain Management in consultation with the Children's Pain
Management Service. First published January 2009. Updated August 2015.
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