What is a continuous epidural analgesia?
Continuous epidural analgesia (CEA) is a technique of infusing an opioid and/or a local anesthetic via an epidural catheter and has been in use at BC Children’s Hospital (BCCH) since 1991. CEA provides pain relief using low doses of opioids and local anesthetics.
How long can we keep epidural catheter?
The epidural catheter is com- monly left in situ for one to four days to provide adequate analgesia in the early postoperative period when pain is most intense. It is the standard practice in our institution and in many others1-3 to provide postoperative epidural analgesia for approximately three days.
What is a neuraxial labor?
Neuraxial analgesia is the preferred method of providing analgesia for labor and vaginal delivery. If needed, the epidural catheter will usually provide anesthesia for cesarean section and other surgical procedures related to pregnancy.
Which local anesthetic is the drug of choice for continuous epidural infusion?
Epidural infusion solutions 0.125% levobupivacaine (Chirocaine) is the usual epidural local anaesthetic solution prescribed. Less commonly, other strengths of levobupivacaine or other local anaesthetics such as ropivicaine are used. More dilute concentrations may be prescribed if less sensorimotor blockade is desired.
How often do you change epidural tubing?
3.8. Tubing should be changed every 48 hours and medication containers every 24 hours, routine dressing changes are not recommended (Lippincott, 2013). 3.9. Anesthesia staff and an obstetrician must be available in-house throughout the time the epidural is in place and functioning.
When can an epidural catheter be removed?
Remove the catheter a minimum of 4 -6 hours after a dose of UFH. Administer the next dose of UFH no sooner than 2 hours after catheter removal. Once daily low-molecular weight heparin (LMWH). Remove the catheter a minimum of 10 – 12 hours after a dose of LMWH.
How long is the epidural needle for pregnancy?
An epidural needle must be long enough to reach the epidural space from the lumbar region of a patient’s back. The average distance from the skin to the space in pregnant women is approximately 4.9cm. A commonly used needle length is 8cm (see photo above).
How long should an epidural hurt?
Sometimes, your physician anesthesiologist will give you a medication to maintain your blood pressure. Sore back – Your lower back may be sore where the needle was inserted to deliver the medication. This soreness should last no more than a few days. There is no evidence that an epidural can cause permanent back pain.
How is an epidural analgesic administered?
A small area on your back will be injected with a local anesthetic to numb it. A needle is then inserted into the numbed area surrounding the spinal cord in the lower back. After that, a small tube or catheter is threaded through the needle into the epidural space.