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Epidural analgesia for children and young people

Epidural analgesia

This leaflet aims to provide information for parents of children who may benefit from an epidural for pain relief after surgery. The information in this leaflet will be discussed with you by an anaesthetist, or a member of the pain team.

What is an epidural?

An epidural is a way of giving pain relieving medicine following certain types of surgery.

Whilst your child is asleep the anaesthetist will pass a small plastic tube (the epidural catheter) into the space around the spinal cord in their back. The tube is held in place by a large plastic dressing.

Pain relieving medicine is given continuously through the tube via a pump. Two types of medicine are commonly used:

  • A local anaesthetic drug
  • A strong pain relieving medicine, such as fentanyl

Who looks after the epidural?

The nurses on the children’s ward are trained to look after epidurals.

Your child will need to have frequent checks of their heart rate, oxygen levels & blood pressure.

The nurse will also check how well the epidural is working by asking your child about their pain, using a cold spray and asking them to move their legs and wiggle their toes.

The pain clinical nurse specialists or an anaesthetist will review your child every day. 

Common side-effects

All strong pain relieving medicines can produce side effects.

Heavy, numb or wobbly legs

It is common for your child to have heavy, numb or wobbly legs whilst receiving an epidural. Normal feeling will return when the epidural is reduced or stopped.

Unable to pass urine (wee)

Your child will have a small tube (urinary catheter) passed into their bladder whilst they are asleep to help them pass urine. This catheter will stay in until the epidural is removed.

Itchiness, feeling sick or vomiting

Some children experience itching, nausea (feeling sick) or vomiting due to the strong pain killer used in the epidural. Medicines can be given to reduce symptoms.

Headache

It is common for your child to get a headache after any operation. Sometimes an epidural can cause a severe headache, which is worse when sitting up. Please let the pain team know if your child experiences severe headache after an epidural.

Pain

Your child will be given additional pain medications to prevent pain alongside the epidural.

Complications

Your anaesthetist will have discussed with you that the benefits of your child having an epidural are much greater than the risk of complications occurring.

Slow breathing

Slow breathing is an uncommon complication of epidural and can be treated.

Nerve damage

Nerve damage can give a loss of feeling or movement in an area of the body. In most people this gets better within a few days, weeks or months. Permanent nerve damage by the needle or catheter is extremely rare.

Epidural catheter infection

Rarely an infection can develop around the epidural catheter. If any problems occur your child’s epidural will be removed. Very rarely, an infection can develop within the space around the spinal cord. This may be treated with antibiotics and your child closely monitored.  

Stopping the epidural

Most children have an epidural for 1–3 days after their operation.

The pain and surgical teams will decide together when the epidural should be stopped. Removing the epidural is not painful. We use glue remover to make the dressing less sticky and then gently pull out the tube.

Your child will need to continue to take pain killers by mouth after the epidural is removed to prevent pain.

Going home after an epidural

After 24 hours the plaster covering the epidural site can be removed. You will need to be reviewed urgently by your GP, or in A&E if your child:

  • Has any signs of redness, swelling or discharge from the epidural site
  • Develops new or worsening back pain
  • Feels that their legs are numb or weak, or they are not able to stand and walk as usual
  • Is not able to hold in their wee or poo, when they are usually able to
  • Feels unwell with a high temperature

Please tell the nurse or doctor that your child has recently had an epidural. 

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