epidurals

Specialties Ob/Gyn

Published

Are you required to keep a patient in bed for a specific amount of time after delivery when a patient has an epidural? We have a new anesthesiologist who wants us to keep our patients in bed for 3 hours after delivery with an epidural. I can't even imagine. I want to do a lit search and see what I can come up with as far as standards go, but wanted to see what everyone else is doing.

Thanks!!!

JenTheRN

212 Posts

Specializes in PERI OPERATIVE.

We have a new anesthetist who has them stay in bed for two hours after epidural is out. The CRNAs usually say when they have full sensation in their legs.

strn96

59 Posts

We let our pts up as soon as they get full sensation in their legs. Of course we make sure a staff member is with them their first time up.

allnurses Guide

Spidey's mom, ADN, BSN, RN

11,304 Posts

We let our pts up as soon as they get full sensation in their legs. Of course we make sure a staff member is with them their first time up.

Yep, which is usually pretty quickly after delivery.

steph

SmilingBluEyes

20,964 Posts

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Our patients are able to ambulate as soon as they are able to hold their weight. The rule is, they must call on staff to assist to the BR for first void. This time can vary. Some epi's wear off fast, others take a couple of hours. All depends. But most are able to ambulate and use the restroom within 2-3 hours' post delivery. Nobody is told they "must" stay in bed any set amount of time. We try to get them up as fast as possible and clean up their beds and teach peri care. Also showers are encouraged when they are hemodynamically stable. Usually this is within a few hours of birth.

HappyNurse2005, RN

1,640 Posts

Specializes in LDRP.

seriously, they want them in bed for 3 hours post delivery if they had an epidural?

we attempt to get them up at approx 1 hour post delivery, sometimes more based on patient, though, usually the attempt is made 1hr-90mins after. i personally stand them up on side of bed, with me having one arm under their arm, one leg between their legs, so if they fall i can sit them back down on the bed and not have them plop on the floor

(with my own 2nd baby, i had the nurse assist me to stand up for first time after delivery and went plop on the floor-thank goodness she helped lower me down...that could have hurt)

if they can't support themselves standing up, back to bed for awhile, or, if busy and we need the bed, they get put in the stretcher chair and taken upstairs.

LPNCieBan

56 Posts

Specializes in Nursing Home/Subacute/LTC.

I recently had an epidural and I couldn't get out of bed for two hours because I couldn't feel my legs.

Elvish, BSN, DNP, RN, NP

4 Articles; 5,259 Posts

Specializes in Community, OB, Nursery.

We let 'em up as soon as they can feel and support themselves on their legs. If that's 30 minutes or 4 hours. Usually it's not more than an hour or two. And the first time we always have them call for help.

mitchsmom

1,907 Posts

Specializes in OB, lactation.

Same as the others... whenever mom has sensation, can support her weight and someone is available to assist her.

tntblonde

11 Posts

Specializes in OB.

we get the up as soon as they have sensation and the ability to move there own legs generally pretty quickly after delivery within an hour or two.

Specializes in Nurse Anesthetist.

The newest thinking on laboring epidurals is that in the past they were much too dense of blocks. The patient needs to have pain relief but not tot he extent that they can't feel their legs. Epidurals should get rid of 70% of the patient's pain, not 100% The sharp pain should be gone, but never the pressure. If the patient is unable to feel her legs (not necessarily tingling, that's ok) then the patient will push much more ineffectively. When the epidurals are too dense, the c-sec rates tend to rise. FYI.

Patients should get up as soon as possible after any procedure. We know from many studies that the longer you lay in bed, the more complications that can occur.

Saying that, I have to agree with many of the above posts, they get up when they can safely do so. That may be in one hour and it may be 3. Depends on the patient and the block.

queenjean

951 Posts

Wow, I think I must work in a very, uh, slow hospital. Like maybe it is 20 years in the past.

Our pts dont' get out of bed for 3-4 hours after the epidural usually, and that is because that's about as soon as they can really feel their legs enough to bear wt and walk on them. 1 hour afterward? No way.

And we definitely give epidurals with the idea of 100% removal of pain. No doubt about that.

Interesting.....

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