TEMPORARY EPIDURAL CATHETER

Temporary epidural catheters are used for treatment of reflex sympathetic dystrophy, chronic back pain, chronic pain in the upper or lower extremities, cancer pain, and/or phantom limb pain.

What is the epidural space?

Epidural refers to the spinal epidural space which holds nerve roots, fatty tissue, lymphatics, and blood vessels.  The epidural space runs from the base of the skull to the sacral hiatus.

What is an epidural catheter?

The epidural catheter is a very small tube (smaller than an IV tube) that is placed through your back into the epidural space.  It is taped securely and a clear dressing is placed over the site.

How does an epidural catheter work?

The catheter that is in your epidural space is connected to a pump that will infuse the medications.  The medicine is in a bag that looks like IV fluids.  These medications (a combination of anesthetics and/or analgesics) will be pumped directly to the nerve roots. You may experience a feeling of numbness or weakness.  You will also get an analgesic effect from the medicines.

It is very important that during this time while your pain is decreased that you work with physical therapy.  It is important to do the exercises that physical therapy prescribes; do them while you are in the hospital.

Preparation for Epidural Catheter Placement

… Do not eat or drink 6 hours before your scheduled appointment time.  This safety measure keeps food out of your stomach in case of an adverse reaction. This allows the nurse to give you sedation during the procedure to help you relax.  If you eat or drink 6 hours prior to the procedure, this could result in a canceled appointment.

… Do not wear necklaces, dangling earrings, or nail polish.

… You need to read and sign a consent form before the procedure.

… An IV will be started.  Also, your blood pressure and heart rate will be monitored.

… You will be asked to sit up during the procedure with your back exposed.

After the Procedure

… You will be in the hospital for 2-7 days.  During this time, the particular nerves that are a part of your pain cycle are numb.  This interrupts the cycle and allows these nerve fibers to rest and hopefully heal.  Your pain relief should be adequate enough so that you can work with physical therapy twice per day.  This is one of the most important parts of your hospitalization.

… You may experience itching; there will be a medication ordered for itching, for which you need only ask.

… If there is a problem emptying your bladder, please tell your nurse so that she can notify the doctor.

… There will be tenderness initially at the catheter site.  This will resolve.

… Notify your nurse if you have a rash.

… You should not be out of bed without assistance.  The medications may make you drowsy and/or weak.