• Reference Number: HEY1101/2023
• Departments: Pain Medicine
• Last Updated: 1 September 2023

Introduction

This leaflet has been produced to give you general information about the aftercare needed following removal of your Epidural catheter.  Most of your questions should be answered by this leaflet/booklet.  It is not intended to replace the discussion between you and your Doctor or Nurse. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

What is an epidural catheter?

The Epidural catheter is a small plastic tube that is inserted into the epidural space in your spine, and allows local anaesthetic and /or analgesia to be given into your spine to block the nerve roots along your spine.

There are some complications that may occur after removal of your epidural catheter, but the risks are generally small. Therefore it is important that you or your carers continue to look for any problems that would indicate there may be complication developing.

It is also important that you inform the nursing/ medical team if you are taking any blood thinners/ anti-coagulants or anti platelet medications (i.e. Warfarin, Apixaban, Edoxaban, Riveroxaban, Dabigatran, Clopidogrel or Ticagrelor) as advice will be needed on when to restart these medications, after the epidural has been removed.

How do I need to look after the area where the epidural catheter has been removed?

If you have a dressing over the insertion site on your spine, then this may be removed 24-48 hours after the catheter has been removed.

You may shower (unless your Dr has told you otherwise), but you should avoid soaking in the bath for 24-48 hours.

What are the complications associated with epidural catheter removal?

The main complications that may occur following the removal of an epidural catheter are;

• Severe Headache – a 1 in 200 risk.
• Haematoma (blood clot) or Bleeding – a 1 in 20, 000 risk.
• Infection – less than a 1 in 100 risk.

These risks can be a minor complication, but can become much more serious if not dealt with promptly. Therefore it is important that you or your carers continue to look for any signs that a complication may be developing.

How will I know if I am developing a complication?

If you have new severe back pain near the epidural site please contact your doctor urgently and / or visit your local NHS walk in centre.

Please contact your doctor if you experience any of the following.

The main symptoms to look out for are:

• Redness and / or swelling around the site. Some redness or swelling is common for the first few days but this should disappear.  However if the swelling or redness is still present after a week.

• If there is any kind of discharge from the insertion site.

• If you develop a fever, temperature, sweats and / or shakes or are feeling generally unwell (with flu like symptoms).

• If you experience intense headaches, which are worse when stood up or moving about and eases when lying flat, then please contact your doctor.

• If you experience any new altered sensation in your arms or legs, such as numbness, tingling or weakness.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.