Epidural Catheter for Pain Relief

An epidural catheter is a way of giving pain medicine through the spine. After your child is asleep, a thin plastic tube (catheter) is placed through the skin into their lower back. The tube is threaded into the epidural space (a space within the spinal canal just outside of the spinal cord). This space has nerves that provide feeling (sensation) to other parts of the body. The tube may be put in near the bottom of your child’s back, or the lower or mid-back.

Most epidural catheters have pain medicines going into them continuously. Older children may also have a button to push that will deliver a pre-set amount of medicine when they feel uncomfortable and need more pain medicine. Usually, the catheter is connected to tubing and a bag of medicine, and then attached to a pump. Epidural catheters may be used to relieve pain after some surgeries of the chest, stomach or legs. It may be also used to treat some cancer pain.

Local numbing medicines called anesthetics are given through the epidural catheter. This is considered “local” anesthesia, in that it goes to a smaller localized area of the body. Other pain medicines, either an opioid (hydromorphone) or clonidine may also be added. Typically, there are fewer side effects when these medicines are given through an epidural instead of through a vein. The amount of medicine given is based on factors such as height, weight and location of the surgery. This may be changed, or a different medicine may be used, if your child is uncomfortable.

The medicine is given through the epidural catheter to reduce the pain messages being carried to the brain along the nerves.

The epidural catheter often stays in place for 1 to 5 days. After it is removed, the pain medicine will keep working for 4 to 12 hours, depending on the type of medicine used.

Side effects are always possible when any medicine is given. The side effects include:

• Itching
• Nausea and vomiting
• Unable to pee
• Feeling sleepy (drowsy)
• Slowed breathing
• Numbness or tingly feeling while the medicine is being given.

If your child has a hard time moving parts of their body, please let your nurse know. The type and amount of medicine can be changed if this occurs.

The nurses will be checking your child often for any side effects. The nurses will also check your child’s breathing, blood pressure and heart rate. Medicines will be given to help with side effects if they occur.

We know pain, you know your child. We encourage you to take an active role in your child’s recovery. Let the nurses and doctors know if:

• Your child is hurting or seems too sleepy.
• Your child itches or feels like vomiting.
• The epidural catheter comes out or is accidentally disconnected.
• You or your child have questions or concerns.

As long as the surgeon says it is OK, your child may get out of bed if certain precautions are followed. The catheter is well taped and should not fall out. A nurse can help your child in getting out of bed or teach you how to hold your child. It is important that we check your child for any leg weakness and that they do not get out of bed alone.

All members of the team are here to partner with you to treat your child’s pain. When your child has an epidural catheter, a member of the Pain Medicine Service visits daily to manage their pain and any side effects of the medicine. If you have questions or would like to speak with a Pain Medicine Service team member at any time, ask your child’s nurse.