Epidural pain control for children

A guide for parents

What is an epidural catheter?

Epidural catheters are one way of giving pain medicine after surgery. A thin tube called a catheter will be put into your child’s skin, near the backbone. The tube will go into the epidural space. The picture shows you where the epidural space is located.

An anesthesiologist puts in the catheter. This is normally done after your child falls asleep for surgery. The catheter is held in place with a special see-through dressing.

• Sometimes the catheter may be used during surgery and then taken out. The medicine will work up to several hours.
• Other times, the catheter is left in place and used to give medicine for up to several days.

The medicine blocks the pain messages sent by the nerves to the brain.

What pain medicine is used?

The most common pain medicines used are:

• Opioids, such as morphine.
• Local anesthetics, like ropivacaine or chloroprocaine, which numb the area. These two medicines are often combined.

How much medicine will my child get?

The anesthesiologist will order pain medicine for your child. It is based on your child’s weight and the type of surgery they had.

After surgery, the Acute Pain Service will see your child and manage their pain. They will help make sure your child is comfortable. If your child is not comfortable, tell the nurse so the amount of medicine can be changed if needed.

If your child has an epidural PCA (patient controlled analgesia) pump, a doctor or nurse is not needed to get more medicine. A button on the PCA pump can be pushed to give a small amount of extra medicine. This can be done if your child has pain or prior to activity. The medicine takes about 20 to 30 minutes to take effect. If your child is not comfortable, tell the nurse so we can adjust the medicine if needed.

What are the side effects?

Side effects are possible when any medicine is given. The most common are itching and nausea. Other possible side effects may include:

• Tingling feeling in the legs.
• A hard time passing urine.
• Drowsiness.
• Breathing that is slower than normal. Your child will be watched closely for any side effects.
• Your child’s vital signs (temperature, pulse, breathing rate, blood pressure) and the epidural catheter dressing will be checked every few hours.
• Other possible side effects have to do with the catheter. These are infection, bleeding, severe back pain and headache. These occur very rarely.

How long will the epidural catheter be in?

The catheter will stay in place for about 1 to 5 days after surgery. It will be removed when it is no longer needed. Your child will feel the tape being pulled off the skin, but normally will not feel the catheter being removed. After it is out, medicine may be given by mouth or in the IV to keep your child comfortable.

For other health and wellness information, check out this resource:

https://kidshealth.org/ChildrensWi/en/parents

ALERT: Call your child’s doctor, nurse, or clinic if you have any questions or concerns or if your child has special health care needs that were not covered by this information.

This sheet was created to help you care for your child or family member. It does not take the place of medical care. Talk with your healthcare provider for diagnosis, treatment and follow-up.