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. After the first 24 hours, vital signs will be monitored at least every 4 hours. Evidence of airway obstruction.
Patient is drowsy, unarousable or excessively somnolent.
Pain relief is determined to be inadequate. For conditions a, b, or c first administer Narcan 0.2mg IVP stat as ordered. If noted the anesthesiologist must be notified immediately. The dressing covering the catheter should not require changing. The catheter is usually left in place two to five days.