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5.3.2 - Management and Administration of Analgesia via an Epidural Catheter
from Section 5.3 - Practical Central Nervous System
- By Jonathan Barnes
Edited by Ned Gilbert-Kawai, The Royal Liverpool Hospital, Debashish Dutta, Princess Alexandra Hospital NHS Trust, Harlow, Carl Waldmann, Royal Berkshire Hospital, Reading
Book:

Intensive Care Medicine

Published online:

27 July 2023

Print publication:

01 December 2021, pp 608-610
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Summary

Key Learning Points
1. Patients with epidurals need careful and close monitoring.
2. It is the dose of local anaesthetic, not the volume, that is of most importance in ensuring adequate analgesia.
3. If the block is too low or absent, try topping up the epidural before removing it.
4. If the block is too high or off to one side, try changing the patient’s position to use gravity to help you alter the block.
5. Always be wary of the hypotensive patient with an epidural. Do not assume it is always down to the epidural, but rather rule out other possible causes.