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Epidurals...do you like them?

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by sunnyside12 sunnyside12 (New) New

I'm undecided...do you think that epidurals are a good source of post op pain management? What is best for the patient in your opinion. What do you hate about epidurals? Thanks-Sunnyside12:bugeyes:

The only thing I didn't like about mine was the puking I did after Duramorph was injected into mine. Other than that it was great. I had great pain control and didn't need anything else.

The patients either have alot of itching problems or else they are nauseated from the post-op epidurals where I work.

I personally liked mine with my 4th child - 3 natural childbirth experiences were enough. :D

I've not experienced many problems with itching or nausea with my patients but they do sometimes get the side effect of hypotension after placement, even with bolusing fluids.

steph

Jolie, BSN

Specializes in Maternal - Child Health. Has 35 years experience.

I am no fan of Duramorph epidurals. In my experience, there is a fairly high percentage of patients who get inadequate relief, or suffer extreme itching.

The last hospital where I worked switched primarily to epidural PCA for post-op patients, and had a much higher satisfaction rate, both from patients' and staff perspective. Better pain control with fewer side-effects.

PCA all the way here. Too many issues to name with epidurals here. Mainly r/t poor staffing and lack of knowledge.

rnmi2004

Specializes in private duty/home health, med/surg. Has 10+ years experience.

Where I work, the anesthesiologists are great at giving us orders to adjust the medication used in the epidural bag if the patient is experiencing side effects. I have seen many of my patients experience excellent pain relief and they are therefore more able to do their pulmonary hygiene, early ambulation, etc. Even though they are more work for me as a nurse, I am a big fan of them.

I personally liked mine with my 4th child - 3 natural childbirth experiences were enough. :D

I've not experienced many problems with itching or nausea with my patients but they do sometimes get the side effect of hypotension after placement, even with bolusing fluids.

steph

Stevie Lynn, that was me exactly - three natural and never again (the third 9lb9 and shoulder dystocia) I had the Fentanyl with the fourth and I loved it - the only problem was they left the catheter in my back for about 8 hours after I gave birth and that was bothering me.

RNperdiem, RN

Has 14 years experience.

For big thoracic surgeries they work very well.

I try to really work the incentive spirometer and turning while the epidural is in.

The doctors know that good pain control post-op matters if patients are going to cough and deep breathe.

There is no perfect way of pain management; everything has its tradeoffs.

Boston-RN, RN

Specializes in LTAC, Telemetry, Thoracic Surgery, ED.

For big thoracic surgeries they work very well.

I try to really work the incentive spirometer and turning while the epidural is in.

The doctors know that good pain control post-op matters if patients are going to cough and deep breathe.

There is no perfect way of pain management; everything has its tradeoffs.

I agree, they're not moving/breathing/IS'ing without an epidural, they lay curled up in a ball

Giving birth to two ... I love the epidural!!

With the first I knew it was good, but I didn't know how good until I had my 2nd.

I think I have a pretty high pain threshold. With my first when I got to a 4 they asked if I wanted the epidural and I told them that I could wait longer. They told me it is better to start it BEFORE the pain REALLY kicks in, because then it takes longer to come down from it. So I agreed to it and I told my husband that I could do this a ton more times if birthing was that easy!

Then when I had my 2nd everything went a lot faster. By the time I got into the hospital I was at a 5 and it was making me really uncomfortable. Before getting the epidural I had to get a whole bag of saline into me. By that time I was a 6 and screaming off the bed with my 2 1/2 year old in the room. It seemed like it was another hour before the anesthesiologist got there. Once I had it I was in heaven!!

When I left the hospital the next day I got a horrible migraine. Right away I knew what it was, because my sister had the same thing happen to her 4 months before at her hospital 2 hours away from me. I cannot remember what it is called, but when your epidural space doesn't close up you have fluid leaking through the hole and causes a bad migraine every time you sit/stand up, and you have to lay flat on your back. They say it can eventually close up on its own, but it is a difficult thing to have happen with a newborn and toddler. So if you can't wait then you have to go into the hospital to have another (low dose) epidural to help close the space up.

Even after all that I would still get another epidural!

This is no advice for you at all, it is just my experience. And as a nurse you should not be trying to sway your patients either way. You just explain to them the pros and cons of both and let them make the choice and support them on whatever they choose. Because when you have a mother in labor you should not be trying to get them to do what you believe in. Trust me, the mother will not be too happy with that and they should not have to banter back and forth with someone at that time what they want. It should be an enjoyable time for them with a new little one on the way.

Hope this helps!

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