Pain assessment and sedation scale is performed on each patient every hour for the first 24 hours then every 4 hours thereafter. If sedation scale is greater than 3, notify the anesthesiologist or designee. Under no circumstances should an IV infusion controller be substituted for an IV volumetric infusion pump or PCEA pump because they cannot generate sufficient pressure to pump the solution through the small diameter epidural catheter. A saline lock or IV must be maintained as long as the epidural catheter is in place and for 12 hours after the epidural infusion has been discontinued. Registered Nursed may not program the infusion pump, but may under the direct order of the anesthesiologist adjust the infusion rate.
Peridural narcotics refer to either spinal or epidural narcotics.
Spinal narcotics are given once, at the time of surgery. Once, at the time of surgery Repeatedly, by bolus injection through an epidural catheter. Continuously, by pump infusion through an epidural catheter. Low concentration of local anesthetics may be added to a peridural narcotic infusion to augment pain relief. Blood pressure, pulse, and sedation level immediately after pump is started or bolus given, then every 15 minutes for 2 hours, then every hour for 24 hours.