Epidurals/Tatoos

[bagladyrn, RN]

There is a thread going on on the OB forum right now concerning the safety of administering epidurals through a tatoo. Apparently some anesthesia providers won't do them if it is necessary to go through an inked area.

I was wondering what you all know about this and what your experience has been.

Thanks!

[MikeyJ, RN]

My brother is a tattoo artist and he tells his female clients that same thing, but I know of family and friends who had lower back tattoo's who were able to get epidurals. I have always wondered the same thing though...

[deepz]

http://www.snopes.com/medical/drugs/tattoo.asp

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[PRESLA]

]Were I have worked depends on MD younger ones will place an epidural where a tat is but the older ones won't go near them. I also worked 3rd and the older MD's got pissed if called in the middle of the night for an epidural so they would us anything for an excuse not to place one. :trout:

Lisa

[Summitk2]

]...depends on MD...

Yes, and it probably depends on the NURSE ANESTHETIST too. Did you notice what forum you're posting in?

[PRESLA]

]CRNA's at the hospital I had worked at would have had a DUCK if they had to place an epidural in a labor pt. They got pissed off if they had to get up out of bed for a c-section during the night.

Lisa

[crnabrian]

Certainly the patient can have an epidural or spinal, as long as it is not a fresh tattoo. Barring other contraindications, of course.

[JoeCRNA]

As a matter of practice, I do not place epidurals through tattoo ink.

The verdict remains out and although the risk is probably small, why take a chance...especially with an elective procedure.

However, there is typically an interspace that is not inked or there is clear skin close enough to an interspace that it can be stretched over the interspace and the needle and catheter subsequently placed through clear skin.

I have placed many catheters right between the antennae of a butterfly or through the centers of many a letter.

[MIM_RN]

When I was in labor with my first child, my anesthesia provider refused to administer an epidural because I had a tattoo in this region. He finally did so, after lots of discussion. (I honestly think he was ticked off because he had to wake up from his nap to administer it.) When having my second child, a different provider did not hesitate to administer it.

[CRNA2007]

What I was taught was if the tattoo was older than 6 months it was fine, but I was also told that they have new acrylic dyes for tattoos, and that you are not suppose to give an epidural or spinal through them.

[JoeCRNA]

What I was taught was if the tattoo was older than 6 months it was fine, but I was also told that they have new acrylic dyes for tattoos, and that you are not suppose to give an epidural or spinal through them.

Some advice for a new CRNA, being a licensed advanced practitioner "I was taught..." is not a good enough rationale for anything. The standard of care, the evidence shows, etc. are rationales. We are not minions to our teachers (whether they be MDA, CRNA, or whoever), we are well trained, independently licensed, well read, mindful professionals, who act on behalf of our patients best interests.

[rph3664]

Yes, and it probably depends on the NURSE ANESTHETIST too. Did you notice what forum you're posting in?

I live in an area with a lot of D.O.s Don't forget them either.