36
Plum
XL
Micro/Macro
8.3
Epidural Administration
Recommended use of the epidural route is to provide
anesthesia or analgesia for periods up to 96 hours.
This device can be used to administer only those
anesthetics/analgesics approved for epidural
administration (as indicated or allowed by the drugs’
FDA approved labeling). Epidural administration of
drugs other than those indicated for epidural use could
result in serious injury to the patient.
For epidural administration, the use of a nylon catheter
(Hospira List No. 1193) or a Teflon
®
catheter (Hospira
List No. 6947), pump sets without Y-sites and "epidural"
stickers indicating ongoing epidural administration are
recommended.
Administration of drugs via the epidural should be
limited to personnel familiar with associated techniques
and patient management problems. Proper epidural
placement of the catheter is essential since catheter
migration could result in intravascular or intrathecal
administration. Facilities practicing epidural
administration must be equipped with resuscitative
equipment, oxygen, naloxone, and other resuscitative
drugs. Adequate monitoring equipment (e.g., Oximetry)
is recommended for continuous monitoring of the
patient during epidural administration. Patients must
be observed frequently for side effects in a fully-equipped
and staffed environment for at least 24 hours following
completion of drug administration by the epidural route.
DELAYED RESPIRATORY DEPRESSION FOLLOWING
CONTINUOUS EPIDURAL ADMINISTRATION OF
PRESERVATIVE-FREE MORPHINE SULFATE HAS
BEEN REPORTED.
The epidural space has 58 openings through which fluid
can exit. Pressure buildup during administration is
transient. However, if a large volume of fluid is
administered over a short time period, the pressure will
