Kids Health Info

Epidural analgesia

  • 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.  

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    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.

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    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

     

    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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Disclaimer
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.