back pain and bruising after epidural

Victoria - posted on 01/18/2015 ( 1 mom has responded )

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I had back pain after my epidural for a vaginal delivery and it went away after 2 years, now it's been 19 years and I now perform epidurals myself. In school we learn that 5% of epidurals don't work that some will be patchy. This is because of anatomy or poor placement but it can happen with a properly placed catheter. The last epidural I did went rough, I kept hitting bone and had to redirect the needle several times until I found the correct spot. The patient was not obese and was correctly positioned sitting like a "mad cat". She got right side relief only, so I pulled the catheter back (the catheter could have progressed too far into the space) however she went into labor shortly after so I did not get a chance to trouble shoot the problem or relieve this poor young mom's contraction pain. I felt totally bad, but at that point there was nothing else for me to do.
She went home 2 days later with a healthy baby but very unsatisfied and apparently with back bruising and back ache. It made the anesthesia department look bad and I've been "talked" to about the incident. I've researched all the reasons for the bruising (aspirin or non steroidals, or other blood thinners), and cannot find anything concrete on it. I certainly don't feel I was otherwise excessively rough. Since I've never had a problem before, my colleagues assure me that I shouldn't worry about it... but I do.
My point is, complications such as back pain, or pain at the site will happen, no matter how easy your epidural was. I just keep expecting retribution by my young patient... and it is troubling.

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Sarah - posted on 01/18/2015

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I worked in L&D and have seen and assisted in hundreds of epidurals. What are you worried about? If you did what you were supposed to do; meet the patient, take her history, review the risks and benefits, explain potential complications, explain the potential for incomplete or ineffective anesthesia, obtained a signed consent from the patient and (most importantly) documented all of the above, then you should not be worried.

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