Post epidural infusion/injection discharge instructions - paediatrics

Who is the leaflet for?

This is for any parent or carer whose child has had an epidural infusion or injection as an inpatient.

Introduction

Nerve damage is a rare complication of epidural placement and this is usually temporary. Permanent nerve damage is very rare (1:10,000). Other serious complications from epidural analgesia are also rare. The epidural space is close to the spinal cord so complications such as a collection of pus or a blood clot in the epidural space may cause pressure on the spinal cord.

In the unlikely event that there is pressure, it is crucial to diagnose and treat it as quickly as possible; this must be done by expert hospital doctors to prevent delays in treatment and long lasting damage, but please be aware that permanent damage is very rare.

This leaflet tells you what to look for and what action to take if you think that your child has a problem.

Assessment before the removal of the epidural catheter

At the end of your child’s epidural infusion the team of doctors and nurses caring for your child will assess your child. This is to ensure that your child does not have any lasting numbness or weakness in their legs from the action of the drugs in their epidural infusion. They will assess whether your child can move their legs freely and examine them to make sure that the sensation in their legs is as it was before the operation. It is important to remember that some operations can cause altered sensation in the legs; therefore, any changes experienced may be as a result of the surgery and not the epidural.

If your child does have altered sensation when the epidural is removed, the doctors and nurses can discuss this with you.

If your child experiences any of the signs and symptoms listed below after their epidural infusion has been stopped, while still an inpatient, ask the nurse to contact the children’s pain team or an anaesthetist immediately.

If your child has any of the signs and symptoms listed below following discharge it is important that your child has an urgent assessment by a doctor. Please attend your nearest Accident and Emergency department immediately and inform them that your child has had an epidural.

Signs and symptoms

• Redness, pus, tenderness, or pain at the epidural site.
• Feeling generally unwell despite the fact that all seems to be well with the surgical wound. High temperature.
• Neck stiffness.
• Numbness and or weakness in your child’s legs. Inability to weight bear/move legs.
• Difficulty passing urine/incontinence of faeces.

Further information

The information in this leaflet is not intended to replace the advice given to you by your child’s anaesthetist or the children’s pain team.

If you require more information or have any questions when you are at home, please contact the children’s pain team on 01223 274825 or contact the operator on 01223 245151 and request transfer to the Paediatric Pain Service.

References

Royal College of Anaesthetists website (opens in a new tab)

Privacy & Dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and/or specialist one to one care is required.