Do you check DTR when pt has epidural?

  1. Do you check DTR when pt has epidural? clonus? homan's sign?
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    Joined: Jul '10; Posts: 126; Likes: 31
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  3. by   Sun0408
    OB is not my specialty but I have cared for a few in the ICU, I check DTR if the pt is on a mag and pit gtt. We did them q4h.
  4. by   Fyreflie
    Nope, never in the three places I've worked. Dermatomes & bromage for epidurals. DTRs for mag sulph patients
  5. by   violet_violet
    What about mag pts with epidurals?
  6. by   monkeybug
    We checked if they were on mag, but I've never heard of doing it on a pt with an epidural. What would be the point?
  7. by   Fyreflie
    Quote from violet_violet
    What about mag pts with epidurals?
    Well yeah, of course but not because of the epi.
  8. by   bagladyrn
    If the patient has an epidural you can check dtr's on the arms - tap at the inner aspect of the elbow and observe "twitch" at the thumb/hand.
  9. by   somedayCNM
    I always do, but only because I maintain an uptight and anxiety ridden attention to detail (not recommended). I expect 0 reflexes. However, the other day I had a patient who had had perfect BP's her whole pregnancy, but was in labor with an epidural in place for several hours and having BP's 160/90. When I checked her DTR's at her knees I got 2+ bilaterally. No other s/s of PIH, and after delivery her BP's started going down. Stress of delivery?? Who's knows.

    Never thought of checking DTRs at the elbows, though. Thanks for the tip!