Epidural factsheet
Introduction
An epidural is a way of giving anaesthetic or pain relief through a thin tube inserted into your child’s lower back. It can help relieve pain by numbing the area of the body where surgery was done.
Epidurals are given by a specialist doctor called an anaesthetist. An anaesthetist looks after anaesthesia and pain management.
Epidurals generally have fewer side effects than other ways of giving pain relief and may be recommended for major surgery on the:
- chest
- abdomen or belly
- lower limbs.
Before the procedure
Before any procedure, the hospital will call you to let you know:
- what time you need to arrive
- when your child needs to stop eating and drinking
- whether it is a day procedure or whether they will stay overnight in the hospital.
Your child’s anaesthetist will talk to you about the epidural, including the benefits, risks, and any alternatives.
An epidural will only be recommended if it gives the best pain relief and recovery for your child.
During the procedure
Your child will be under a general anaesthetic for the procedure. This means they will be asleep and will not feel any pain.
The epidural will be given once your child is under the general anaesthetic.
- the anaesthetist uses a special needle to insert a thin tube called an epidural catheter into your child’s lower back
- the tube will go into the space just outside the spinal cord, called the epidural space
- once the tube is in place, the needle is removed
- the tube is covered with tape so that it cannot be pulled out
- a plastic dressing is placed on your child’s back.
Some children will also need to have a urinary catheter while they have an epidural. A urinary catheter is a thin tube inserted into the bladder to drain the bladder.
The urinary catheter will be inserted during your child’s procedure.
After the procedure
The epidural will stay in place after the operation. It will be connected to a pump that gives a mixture of medicines, including pain relief and a local anaesthetic that numbs the lower half of the body.
If the epidural is working well, your child won’t feel any pain in the area covered by the epidural.
They may be able to feel the tape and dressing on their back, and they may feel a bit strange if they move around.
Let your child’s treatment team know if they are feeling:
- any pain or discomfort
- numbness
- cold skin
- heaviness in their legs.
Your child should not try to walk on their own while they have an epidural. Let your child’s nurse know if they want to move out of bed.
Epidural time
The length of time the epidural stays in will depend on:
- what type of procedure your child had
- the level of pain that is expected after the procedure
- your child’s recovery and how well they are eating and drinking.
Epidurals need to be removed after five days to prevent infection. The epidural may be removed earlier if it’s not working correctly or giving enough pain relief.
Removing the epidural
To remove the epidural:
- the pump will be turned off
- the tape on your child’s back will be gently removed
- the catheter will be pulled out slowly.
If your child has a urinary catheter, it will also be removed gently.
Removal of catheters should not cause any pain.
Once the epidural is removed, it can take up to six hours for the medicine to wear off and for your child to regain feeling in the lower half of their body.
While this happens, your child will be given pain relief:
- by mouth – liquid or tablets
- through an intravenous (IV) cannula – a thin tube in their vein.
Your child’s treatment team talk to you about continuing pain relief after the epidural is removed.
Management
Side-effects
Epidurals are effective and safe for children of all ages. Your child will be checked closely while they are in the hospital to make sure they are recovering, and the epidural is working well.
Epidurals have some side effects, which your child’s treatment team can manage. These include:
- headaches
- itchy skin
- vomiting
- infection
Epidurals can also carry some risk, which the anaesthetist or surgeon will discuss with you.
The most serious risks are extremely rare, and include:
- severe allergic reaction to the medicine
- harm to the nerves in the spinal cord.
Speak to your child’s treatment team if you have any concerns or questions.
