Epidural infusions

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Your child needs medicine to manage pain. They may have an epidural infusion to get this medicine. This page explains what an epidural infusion is and what will happen when your child has one.

Key points

An epidural infusion uses a catheter to put pain medicine directly around the nerves of the spine.
Your child will be checked for any problems while they have the infusion.
An epidural infusion usually lasts from one to five days.
Most side effects from an infusion are not serious.

Introduction

What is an epidural infusion?

An epidural infusion is a way of giving pain medicine. Epidurals are usually used during and after surgery and are inserted by health-care specialists called anaesthesiologists while your child is asleep. Pain medicine is given through a small tube called a catheter in your child’s lower back into the epidural space. The epidural space goes from the bottom of the skull to the tip of the tailbone. Epidurals are usually used during and after surgery (an operation).

Cross-section of spine showing spinal cord, meninges, epidural space and epidural tube with arrows showing fluid movement — A tiny tube is inserted between the two vertebrae in the spine. The epidural space is the space around the spinal cord and nerves. The tube delivers anesthesia medication into the epidural space during an operation and for a time after.

More information

Why is an epidural infusion recommended?

There are a number of reasons your child’s health-care team may recommend an epidural infusion. For example, with an epidural infusion, your child may:

require less general anaesthetic during surgery
use less opioids or other strong medicine after the surgery
have better pain control
feel less nausea after surgery
have quicker return of normal poops after surgery (other ways of giving pain medication can affect the bowels for longer)

Epidural infusions are safe and effective for some types of surgery and for some types of chronic pain. The anaesthesiologist will decide if an epidural infusion is the right fit for your child.

About the treatment

How does an epidural infusion work?

The epidural catheter is connected to a special pump. This pump is always putting some pain medicine into the catheter. This medicine includes a “numbing” medicine called a local anaesthetic. The pain medicine surrounds the nerves in your child's spine. The epidural infusion can continue for a number of days. In special cases, an epidural catheter can be used for a number of weeks.

A clear bandage or dressing keeps the catheter in place.

Treatment

Monitoring during the infusion

While your child has an epidural infusion, the nurses will watch for any problems. The nurses will check your child's blood pressure and heart rate. Your child's movement and feeling to parts of the body affected by the medicine in the epidural infusion will also be monitored. The nurses will also check the area on your child's back where the catheter is.

While the epidural infusion is in place, your child’s nurses will help your child to turn from side to side in bed, sit up and move. Often, children with epidurals can walk and move around their room. Your child will also be on a heart and breathing rate monitor to watch for any side effects.

Checking and adjusting for pain

Your child's nurse will regularly ask your child how well the medicine is working. Your child may feel some pain.

If your child has pain, the doctor may increase the amount of medicine for the pain or change the type of medicine that your child gets. The doctor may also give medicine by mouth (orally) in addition to the epidural infusion.

Your child may have the epidural infusion for a few days

Epidural infusions are usually given for one to five days. The length of time will depend on the type of operation and the amount of pain that your child has.

When it is time to take out the catheter, it will be gently pulled out. It does not hurt to remove the catheter. Some children may not like the dressing tape being gently removed from around the catheter.

Your child will then get pain medicine through the existing intravenous (IV) line or as a pill or liquid that they can swallow. An IV is a small tube that is put into a vein in your child's arm or leg to give medicine or fluids.

Complications

Side effects from an epidural infusion

Side effects are problems caused by the medicine. The side effects your child may have depend on the kind of medicine that they get. Most side effects from epidural infusions are not serious.

Your child may have some of these problems:

feeling nauseated or sick to the stomach
throwing up (vomiting)
itchiness of the face, neck, chest or back
weakness or numbness of the legs (depending on where the epidural catheter is inserted)
problems with urination (passing urine or peeing). Your child may have a urinary catheter while they are receiving the epidural infusion.

Other medicines can help with these side effects.

For more information

Please ask your child's health-care provider if you have any questions.

Resources

AboutKidsHealth — Pain learning hub

Last updated: abril 4th 2024