epidurals in NICU

[nicugrad]

I was wondering if there is anyone out there who uses epidurals in neonates for pain control. Our hospital is starting to use them but it is new to us. How and what do you do to check for assessments? What are your protocols at your NICU? Thanks.

[NeoNurseTX, RN]

We get one once in a blue moon. I think I've had two babies with them. I actually don't see anything in our P&P manual related to them though.

[BabyLady, BSN, RN]

I have never seen our facility use them. We are Level III.

I have seen morphine, fentanyl, fentanyl drips with paralytics used. But never an epidural.

As a parent, a physician would really, really have to have some serious evidence before I would agree to go that route.

[littleneoRN]

I don't have much experience with them, but we use them occasionally for more substantial abdominal surgeries.

[BabyRN2Be]

My cousin had a CDH baby in 2002 and they used an epidural +24 hours post-op. This was at Children's Hospital Boston in their CDH specific NICU.

[carrotstix]

My cousin had a CDH baby in 2002 and they used an epidural +24 hours post-op. This was at Children's Hospital Boston in their CDH specific NICU.

The only baby I have seen with one was a CDH'er post-op. But it was in Cleveland.

[ToughingItOut]

Our hospital uses them all the time...mostly for post-abdominal surgeries. Honestly, they're great when they work, but they seem to have complications more often than not (leaking, poop all the way up the dressing, unexplained poor pain control). If you're lucky, the pain control team/anesthesiology will come up and change the dressing and take a look... Most of our epidural babies also receive IV gtts for pain, so a lot of times they just end up pulling the epidurals after a day or two. Also, documentation is a HUGE pain: you have to press all these ridiculous buttons every two hours and at change at shift and document amount infused, remaining, etc.