Epidural Pain Control For Adults

What is epidural pain control?

Epidural pain control is when pain medicine is put into the space around your spinal cord (epidural space). An epidural is a way to get pain medicine without repeated injections. An epidural can help decrease acute (short-term) pain from childbirth, surgery, or an accident. It can also be used to decrease long-term pain, like cancer pain.

How is the epidural catheter put in?

  • A temporary catheter can be put in your back in the operating room, your hospital bed, or your caregiver's office. You will be asked to lay on your side or sit on the side of the bed. The skin on your back will be numbed with medicine to decrease feeling and pain. A needle is put in between 2 bones in your back. A catheter (thin plastic tube) is threaded through the needle. The medicine is put into the catheter. With a temporary epidural, the catheter is taped to your back and shoulder.

  • You will go to the operating room to have a permanent catheter placed in your back. You may be given medicine to make you go to sleep during the procedure. The permanent epidural catheter comes out of a small incision on your side or near your belly button. This is called the exit site. You will also have small incisions with stitches in your back and side. This is where the catheter was put under your skin.

How does an epidural work?

A small pump attached to a syringe filled with pain medicine is hooked up to the catheter. There are different methods of pain medicine delivery:

  • A basal rate is a small amount of pain medicine that goes into the catheter tube all the time.

  • Caregivers may put medicine into the catheter when you tell them that you have pain.

  • You may have patient-controlled analgesia (PCA), which is a button you can push to release medicine into the catheter.

  • You may have both a basal rate and a PCA for when you need more pain medicine.

Who should press the PCA button?

Current guidelines state that only the patient should press the PCA button for pain relief. If you think that someone else should press the button for you, talk to your caregiver. Tell your caregiver if you are still uncomfortable after you push the button. A PCA machine is set up so that you are not able to give yourself too much medicine. Ask your caregiver for more information about PCA.

What are the risks of an epidural?

An epidural may cause an infection or bleeding in the epidural space. The medicine may not completely control your pain. The medicine could numb your muscles so much that you cannot move or walk. The medicine could decrease your blood pressure too much. It may also make you breathe too slowly or not often enough. Your skin may be itchy or you may have trouble urinating.

When should I contact my caregiver?

Contact your caregiver if:

  • You feel that your pain is not being controlled by the medicine.

  • The skin around your incisions is red or swollen, or the incision has pus draining from it.

  • You have trouble moving, urinating, or having a bowel movement.

  • You have questions about or problems with your medicine pump.

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You have a fever.

  • You have trouble breathing, are dizzy, or have itchy skin or a rash.

  • You have a stiff neck or trouble thinking clearly.

Care Agreement

You have the right to help plan your care. To help with this plan, you must learn about your pain and how an epidural can be used to treat it. You can then discuss treatment options with your caregivers. Work with them to decide what care will be used to treat you. You always have the right to refuse treatment.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.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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