The epidural catheter will most likely be left in place for 24 to 48 hours after the operation, to provide analgesia for post-operative pain. The epidural will usually start to wear off about 1 to 2 hours after the operation. Pain relieving medications are usually narcotics (such as Pethidine or Fentanyl) and can be given through the epidural catheter either:
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Periodically (every 2 to 3 of hours) by the caregiver on the postnatal ward, |
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Slowly and continuously with an electric syringe pump (this may only be available in some hospitals), OR |
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Controlled by the woman pressing a button, to self-administer the pain relief when she feels she needs it. This is referred to as 'PCEA' or 'Patient Controlled Epidural Analgesia'. |
Patient controlled epidural anaesthesia (or PCEA) is when the woman self-administers doses of the epidural medications to control her pain relief after the operation. It works on similar principles to
Patient Controlled Analgesia (or PCA), which is often used for intravenous (IV) pain relief after using a spinal or a general anaesthetic for the Caesarean.
A large syringe with the epidural medications are attached to a push button, hand held device. The woman is shown how to use the device. When the she starts to feel uncomfortable she can press the button to administer a small dose of medications through the epidural catheter. There is usually a lag period of about 5 to 10 minutes before the new dose of medications take full effect.
The device has a set 'lock-out' time that prevents the woman from giving herself too much medication if the button is pressed multiple times, over a short period.
Removing the epidural catheter