Continuous Lumbar Epidural

Prepare your equipment and apply an antiseptic solution to the patient’s back.

Create a sterile field.

Identify an appropriate lumbar spine interspace.

Administer local anesthetic to numb the skin.

Then anesthetize the deeper tissues.

Insert the epidural needle close to the ligamentum flavum. You should not encounter any resistence.

Attach a syringe filled with air.

Each time you advance the needle, see if the air can flow easily into the epidural space. Only after you pass the ligamentum flavum will the air flow smoothly.

Give a test dose of local anesthetic to be sure you’re in the right space.

Then give the full dose of anesthetic.

Pass the catheter through the needle and into the epidural space.

Remove the epidural needle, sliding it off the end of the catheter.

Secure the end of the catheter with an injection port.

Spray the back with adhesive.

Secure the epidural catheter in place, using foam, and adhesive tape.

Re-dosing is done through the injection port.