Epidural Pain Control For Adults

WHAT YOU SHOULD KNOW:

• Epidural (eh-pih-DUR-ull) pain control means putting pain medicine through a catheter (very thin plastic tube) into the epidural space. The epidural space is the area around the spinal cord in your back. A small pump attached to a syringe filled with pain medicine is hooked up to the catheter. A "basal rate" is a small amount of pain medicine running into the catheter tube all of the time. The medicine may also be given on an as-needed basis, either by your caregiver or yourself. Caregivers will work with you to make sure you get enough medicine to control your pain.
  
  
• Using an epidural for pain control is a way to use pain medicine without the need for repeated injections (shots). Epidurals have been used to decrease the pain of childbirth for many years. Now epidurals can be used to treat pain from many other conditions. It can help decrease acute (short-term) pain, like after surgery or an accident. Chronic (long-term) pain, like cancer pain may also be treated with an epidural.

AFTER YOU LEAVE:

Medicines:

• Keep a written list of the medicines you take, the amount, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Learn why you take each medicine. Ask your caregiver for information about your medicines. Do not take any medicines without first talking to your caregivers.
  
  
• Always take your medicine as directed by your caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking a medicine until you discuss it with your caregiver. If you are taking antibiotics (an-ti-bi-AH-tiks), take them until they are all gone even if you feel better.
  
  
• Pain medicine will often make you drowsy. Do not drive or use heavy equipment while taking medicine for pain.
  
  
• Caregivers will help you and your family learn more about the epidural catheter and the medicine you are taking. Ask your caregiver to show you how to give yourself this medicine and how to care for your catheter. Take enough medicine to stay comfortable. Do not worry about becoming addicted to the pain medicine.

How do I care for the exit site?

The exit site should be kept clean and covered. Caregivers may teach you how to take care of your exit site. If caregivers tell you to, change the bandage every day for the first 7 days. After that, change it every second day. Change your bandage any time it becomes loose, wet or dirty.

How do I change my exit site bandage?

Gather the following things to change your bandage:

• 4 Sterile cotton swabs.
  
  
• Betadine™ solution.
  
  
• 2 Sterile pre-cut gauze pads.
  
  
• 1 Sterile 4x4 gauze pad.
  
  
• A roll of one inch wide tape.

• Wash your hands very well with soap and water, and dry them completely.
  
  
• Take the old bandage off. Do not pull on the catheter.
  
  
• Look at the exit site. Tell your caregiver if you see redness, swelling, drainage, or any other changes.
  
  
• Clean the skin around the catheter at the exit site with a cotton swab dipped in Betadine solution. Clean your skin in a circle, starting at the catheter and moving out about 3 inches. Throw away that cotton swab. Repeat this step 2 more times.
  
  
• Using the fourth cotton swab dipped in Betadine solution, wipe the catheter gently. Start from the exit site and go up to the filter.
  
  
• Cover the exit site with a pre-cut sterile gauze pad. Gently put the catheter through the pre-cut slit in the pad. Do not touch the side of the pad that will be touching your skin.
  
  
• Turn the second pre-cut gauze pad so the slit is turned in the opposite direction of the first pad. Put it over the exit site, gently putting the catheter through the slit.
  
  
• Cover it with the 4x4 gauze pad.
  
  
• Tape the edges of the gauze pad.
  
  
• Loop the catheter over the dressing and tape the catheter in place.

How do I change the filter on the machine?

Caregivers may teach you to change the filter and tubing for the medicine. Follow these steps to change the filter and the tubing:

• Wash your hands very well with soap and water. Dry them completely.
  
  
• Gather the following items:
  
  
  • Sterile filter.
    
    
  • 1 Sterile cotton swab.
    
    
  • Betadine™ solution.
    
    
  • A roll of one inch wide tape.
  
  
• Open the filter and injection cap package. Remove the pre-attached cap from the new filter. Do not touch the end of the filter.
  
  
• Hook the new filter to new tubing on the new medicine bag and let the medicine flow through the filter.
  
  
• Remove the tape from the old filter.
  
  
• Wipe the area where the filter is attached to the catheter with a cotton swab dipped in Betadine™ . Allow it to air dry.
  
  
• Remove the old filter. Ask your caregivers how or where to throw it away. Make sure to keep it away from children and pets.
  
  
• Hook the new filter to the catheter.
  
  
• Tape the area where the filter hooks to the catheter to keep it from coming undone.

When can I take a shower?

You may take a shower 1 week after the catheter has been placed. Cover the catheter and exit site with a waterproof covering such as plastic food wrap. Tape around the edges of the wrap to keep it from leaking. Put a clean bandage on your exit site after showering.

CONTACT A CAREGIVER IF:

• You feel that your pain is not being controlled by the medicine.
  
  
• The skin around your exit site, side, or back incisions are red, swollen, or have pus coming from the incision (cut). This may mean that you have an infection.
  
  
• You have trouble breathing, are dizzy, or your skin is itchy, swollen, or has a rash. Your medicine may be causing these symptoms. This may mean you are allergic (uh-LER-jik) to your medicine.
  
  
• You have trouble moving, urinating, or having a BM. These may be side effects of the medicine.
  
  
• You have questions or concerns about your injury, illness or medicine.
  
  
• You have questions about, or problems with your medicine pump.

SEEK CARE IMMEDIATELY IF:

• You have a fever.
  
  
• You have a stiff neck or trouble thinking clearly.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.