Key Points

• an epidural will keep your child free from pain after major surgery
• your child’s epidural will usually stay in for two to three days after their surgery

What is an epidural?

An epidural is a very effective method of pain relief used both during and after major surgery to the chest, tummy (abdomen) and legs (lower limbs).  While your child is asleep under anaesthetic, a long piece of thin plastic tubing (epidural catheter) is placed into the epidural space in your child’s back through a special needle which is then removed. The epidural space is an area through which the nerves travel after they leave the spinal cord.

How does an epidural work?

Once the epidural catheter is in place, a ‘numbing’ drug call a local anaesthetic is injected down the catheter.  This means that your child should be free from pain when they wake up in the recovery room after their operation.  If they are not free from pain the nurse or doctor will give them some pain medication (morphine) through the intravenous line (IV line).  They will place a machine (infusion device) to your child’s epidural catheter.  The machine contains a bag of epidural solution.

This will give your child a continuous amount of local anaesthetic to keep them free from pain on the ward.  Sometimes other drugs (such as fentanyl or clonidine) are added to the local anaesthetic to improve their pain relief.

Who makes sure the epidural is working?

The ward nurse will monitor (keep an eye on) your child’s epidural.  If there are any problems they will contact the specialist nurse or doctor.  Occasionally the epidural may not work very well.  If this happens the specialist nurse or doctor will visit them and give some extra local anaesthetic down their epidural catheter, or they will change you to a different pain control technique.

What will my child feel like with an epidural?

Your child’s epidural should keep them free from pain in the area where they had their operation.  Depending on where the epidural has been placed in your child’s back, they may not be able to move their legs, or their legs may feel weak and ‘wobbly’. Your child may also have a plastic tube called a urinary catheter in their bladder.  This is because they won’t feel like they want to use the toilet.  This is also put in when your child is asleep in theatre.

How long will my child’s epidural stay in?

Your child’s epidural will usually stay in for two to three days, depending on the type of surgery they have had.  When your child no longer needs it, the ward nurse will remove the epidural catheter from your child’s back.  This is not painful.  The nurse will then give your child other pain medications if they need them.  This may be pills or syrup that they swallow or intravenous pain medication (usually morphine) through their intravenous line.

Acknowledgements

Starship Foundation and the Paediatric Society of New Zealand acknowledge the co-operation of the Starship Children’s Hospital, Auckland District Health Board in making this fact sheet available to patients and families.