• To make you as comfortable as possible while you recover.
• To reduce your pain without sedation so you may start walking, doing your breathing exercises and getting your strength back more quickly. You may even leave the hospital sooner.
• Improve your results. You may avoid some problems, such as pneumonia and blood clots, that may affect others.

How does epidural analgesia work?
Pain medication will be given through a small tube, called an epidural catheter, placed in your back.

An anesthesiologist will decide the type of pain medication, how much and how often you receive it.

A pain medicine pump will be programmed to deliver medicine continuously through your epidural catheter. It will be programmed to give you an amount of pain medication that is typically safe for someone of your sex, size, age and diagnosis or type of surgery.

Do not take any other pain medicines or sedatives unless ordered by your physician or pain management physician.

Epidural catheter placement
If you are having surgery, the epidural catheter will be inserted in the pre-op holding area, in the operating room following your procedure, or in the recovery room.

You will be positioned on your side or sitting up with your back arched out toward the anesthesiologist.

Your back will be washed with a cool solution.

The physician will inject anesthetic to numb the insertion site. You may feel some pressure while the physician finds the epidural space.

A very small catheter will be inserted through a needle into the epidural space and the needle is then removed.

The catheter is taped to your back and up to your shoulder where it is connected to the pain infusion pump.

While the catheter is in place, you may lie on your back, turn, walk and perform any activities your physician approves.

Important points
The pain management physician, the acute pain clinician and the nurses caring for you on the hospital unit will follow your progress carefully. There will be frequent checks on your blood pressure, pulse, breathing and level of sedation. You will be asked to rate your pain using a 0-10 scale. (0=no pain, 10=worst pain imaginable) Your reports are important as they will help the pain management team make necessary adjustments in your care to keep you safe and as comfortable as possible.

Most patients with an epidural will have supplemental oxygen for the first 24 hours after surgery. Your doctor or the pain management physician will decide when this can be stopped.

Most patients with an epidural will have their oxygen level measured by a machine called an oximeter. The oximeter is connected to your finger or one of your toes. Your doctor or the pain management physician will decide when to remove the oximeter.

Your part in pain control
Report your pain rating using the 0-10 scale.

Tell your physician or nurse about pain that won't go away. It is realistic to expect some pain with coughing, moving about in bed or walking, but your pain level should go down when these activities are stopped.

Tell your physician or nurse if your pain treatment is not as effective as you would like.

Also report any of these reactions: itching, nausea, problems with urinating or constipation, feelings of increased sedation. Your nurse can then report this to your physician so adjustments can be made to your care.

For more information about epidural analgesia, call Baptist Hospital East's Center for Pain Management at (502) 896-7246.

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