Key points about epidural analgesia in children
- an epidural helps manage your child's pain
- your child’s epidural will usually stay in for 2 to 3 days after surgery
What is an epidural?
An epidural is a very effective method of pain control used both during and after major surgery to the chest, tummy (abdomen) or legs.
Your child's anaesthetist is a specialist doctor who keeps your child asleep and comfortable during a surgical procedure. The anaesthetist will put your child's epidural catheter in place.
What happens during an epidural
Your child has an anaesthetic
First, the anaesthetist will give your child an anaesthetic so that they're asleep.
A special needle goes into your child's back
Then the anaesthetist uses a special needle to put a piece of thin plastic tubing (an epidural catheter) into the epidural space through the skin on your child's back. Nerves that sense pain travel through the epidural space. Medicine put in the epidural space helps stop these pain messages.
The needle is removed
The anaesthetist then removes the special needle.
How an epidural works
Once the epidural catheter is in place, the anaesthetist will inject a 'numbing' drug called a local anaesthetic down the catheter. This means that your child should be comfortable when they wake up in the recovery room after their operation. The epidural catheter is connected to a machine (infusion device). The machine contains a bag of epidural solution.
This will give your child a continuous amount of local anaesthetic to keep them comfortable on the ward. Sometimes the pain or anaesthesia team will add other drugs (such as fentanyl or clonidine) to the local anaesthetic to improve pain relief.
Checking the epidural is working
The ward nurse will keep checking your child and the epidural. If there are any problems they will contact the specialist nurse or doctor. Occasionally the epidural may not work very well. If this happens the specialist nurse or doctor will visit and give some extra local anaesthetic down the catheter. Your child may also receive some pain medicine (morphine) through an intravenous line (IV line). Sometimes, if the epidural isn't working well, a different pain control method may need to be used.
What an epidural feels like
Your child's epidural should manage your child's pain. Depending on the level of the epidural catheter, your child's legs may feel weak, heavy or 'wobbly’' This is completely normal. Your child may also have a plastic tube called a urinary catheter in their bladder. This is because they won't feel like they need to wee. The urinary catheter will be put in when your child is asleep in theatre.
How long epidurals stay in for
Your child's epidural will usually stay in for 2 to 3 days, depending on the type of surgery they have had. When your child no longer needs it, the ward nurse will remove the epidural catheter from your child's back. This is not painful. Sometimes, removing the plaster holding the epidural catheter in place can be uncomfortable. The nurse will then give your child other pain medicines if they need them. Medicine may be pills or syrup that your child can swallow or intravenous pain medicine (usually morphine) given through their intravenous line.
Acknowledgements
Starship Foundation and the Paediatric Society of New Zealand acknowledge the cooperation of the Starship Children’s Hospital, Auckland District Health Board in making the content on this page available to patients and families.
