Pain Management

Pain Management Methods:
Epidural and Patient Controlled Epidural Analgesia

Epidural Analgesia
An epidural is a method of giving you opioids (pain relieving medicine) and/or local anesthetic (numbing medicine like at the dentist) through a very small tube placed in your back near your spinal nerves. This tube or catheter is smaller than the smallest spaghetti noodle and is held in place with tape over the middle of your back.

An epidural is usually put in while you are awake. You will receive numbing so that this procedure does not hurt. The epidural may also be used to give you anesthesia during surgery. This is the most common method of relieving pain after surgery.

Patient Controlled Epidural Analgesia
An epidural may also be patient controlled. This will mean that you have a button to push to give yourself additional medicine into the epidural space. The medicine that you give yourself will take about 20 minutes to work.

IT IS IMPORTANT THAT ONLY YOU PUSH THE BUTTON OF THE PATIENT CONTROLLED EPIDURAL. PLEASE ASK YOUR FAMILY AND FRIENDS NEVER TO DO THIS FOR YOU BECAUSE THEN THE SAFETY FEATURES OF THE PUMP DO NOT WORK.

The advantages of an epidural include:

1. Continuous delivery of medication for three to five (3 to 5) days after surgery or until you can take pain medicine by mouth
2. Patients often report their pain level is less when using this method.
3. There are decreased side effects with this type of medicine.

The side effects of this method may be:

1. constipation
2. itching
3. sleepiness
4. numbness in your legs
5. difficulty moving your legs
6. difficulty urinating
7. nausea
8. numbness around your mouth
9. a funny taste in your mouth

Your Responsibilities
You will have some responsibilities with this type of pain management. Your nurse will have to wake you every hour for the first 12 hours and then every two (2) hours for the next 12 hours. S/he will ask you your pain level on a 0-10 scale. If your pain is not under control you must tell us as quickly as possible. It is easier to manage pain before it starts than to wait until it is out of control. The nurse will wake you and keep a close eye on you to make sure your pain is well managed and that you are not experiencing too many side effects.

You must notify your nurse if alarms sound or any unusual symptoms develop. These may be:

1. itching
2. trouble breathing
3. nausea
4. numbness in your legs
5. difficulty moving your legs
6. a funny taste in your mouth
7. ringing in your ears
8. numbness around your mouth

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