Tattoos and epidurals

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Mewcakes

Mewcakes

SCO c/o 2014
10+ Year Member
Joined
Feb 10, 2010
Messages
421
Reaction score
4
Hi Drs. I was wondering if there are any problems giving epidurals to women in labor if she has a tattoo over the epidural site? I'll admit that I don't even really know where that is. Between L4 and L5? Can you go between L3 and L4 instead? I'm basically curious if getting a tramp stamp will pose complications for me during childbirth. 😛
Members don't see this ad.
 
There've been some lay articles about it, although I've never seen any scientific literature on it. If you were really curious, you could always pubmed this. That said, tatoos obviously represent ink molecules under the skin, and if you pierce this with a huge needle, you may carry some of these molecules wherever the needle goes. Maybe it doesn't matter.

The larger issue, in my opinion, regarding tramp stamps and complications of labor are related to actually getting pregnant in the first place. Maybe some guys are into girls with the stamp, but I'd actually be less likely to hit it under those circumstances, so your odds of getting impregnated by me is actually lower.
 
Members don't see this ad :)
I would say the vast majority, possibly > 90% of the women on our L&D have tatoos above their rump. It is rare enough to have virgin skin there that it actually stands out in my mind when I see it.
Usually it is not where I need to do the epidural. If it is, I just go right through as if it weren't there.
One time I asked a girl what the chinese (?) character stood for. After a "pregnant pause" she said "pleasure". That was an awkward moment. I've never asked again.
Tuck
 
I've heard rec's that you should avoid a fresh one, maybe wait 6-8 wks. Can't say there is any literature on this. Obviously, if the edges are still red, swollen and weeping blood, I'm not getting my needle anywhere near it. So make sure you get the stamp BEFORE you get pregnant.

More importanly, make sure you go to a quality shop, and that the "open for business" sign gets placed in the midline. Nothing pisses me off more than struggling to find midline in an obese parturient, only to be confused by some ridiculous piece of "expression" that's about a cm off midline. I've actually commented before to pregnant women, telling them where the needle pierced the tat, and praising their artist for placing it directly over midline.

**Note- I'm not saying you're obese now, or that you will be. I respect your decision to transform your body. The above anecdote was based on my prior experiences with other women.
 
You stay classy cchoukal.👍
 
Do not get stamped and then tell me that you are afraid of needles. It is not classy.
 
i don't buy into the ink into the epidural space hypothesis however I try to avoid going into it if I can because you may create a scar and hence ruin the way it looks so I always let them know. I had a partner who got sued over it because it "ruined the tat" and she would not have gotten the epidural if she knew it could happen. Let me just say that you should not get said tat because you will grow up some day and regret it. I know more then one person who hates that they have been stamped for life. I always respond if it walks like a duck, and quacks like a duck...blaz
 
Recently placing epidural in attractive 30-something with Chinese character tat on shoulder:

me: "Oh, what does your tattoo say?"

her: (with half-smile and holding her head in one hand while shaking it side-it- side) "It means I'm 19 and dumb!"

Gotta give her credit, she had a great sense of humor about it.
 
lol. Good answers. You guys are way funnier than the ppl that hang out in the OD forums. GJ. 😛
 
I had forgotten about his until just now but a few months ago I put a labor epidural in a >450 pounder with some cursive writing in the tramp stamp area. I had a hard time reading it.

Me: What does this say?

Her: It says "insatiable." It means I can't be satisfied

Me: Yes, I can see that
 
Members don't see this ad :)
bigeyedfish said:
I had forgotten about his until just now but a few months ago I put a labor epidural in a >450 pounder with some cursive writing in the tramp stamp area. I had a hard time reading it.

Me: What does this say?

Her: It says "insatiable." It means I can't be satisfied

Me: Yes, I can see that
Click to expand...

LOL!! :laugh:
 
Some people talk about the "new" inks out that have metalic particles in them being potentially bad. I don't necessarily agree, but just so you know that some may decide not to go through it. Others say to prenick the skin with a different needle so you are going through the ink with a different needle than you are going through subcutaneous etc.
My personal opinion is that I don't care and do not believe that 1. The skin ink is translocated into the epidural space, and 2. that it matters if it is. I do agree that off center back art is really lame.
 
This subject was discussed at a lunch panel at the ASA meeting last October. Several "experts" on the panel and what appeared to be some very experienced OB anesthesiologists in the audience.

Bottom line: nobody really knows. There's no evidence that dyes move into the epidural space with the needle. (BTW, older dyes are metal salts but some of the newer, brighter colors are actually microscopic plastic beads). Also no evidence that any of these materials are neurotoxic. And no case reports of complications. Not that "no evidence of toxicity" is that same as "no risk", but...

I won't do an epidural on someone with a fresh tattoo, but I sort of doubt anyone would/could tattoo a woman in her 8th month anyway.

I might mention that "I have no choice but to put the needle through the tattoo and no one knows if that's risky but I doubt it."

I don't trust the tattoo to guide me toward the midline.

I have no sympathy for the tattoo- and piercing-endowed who says she is afraid of needles.
 
cchoukal said:
There've been some lay articles about it, although I've never seen any scientific literature on it. If you were really curious, you could always pubmed this. That said, tatoos obviously represent ink molecules under the skin, and if you pierce this with a huge needle, you may carry some of these molecules wherever the needle goes. Maybe it doesn't matter.

The larger issue, in my opinion, regarding tramp stamps and complications of labor are related to actually getting pregnant in the first place. Maybe some guys are into girls with the stamp, but I'd actually be less likely to hit it under those circumstances, so your odds of getting impregnated by me is actually lower.
Click to expand...

HAHAHAHAHAHAHAHAHAHAHAHAHA
thats some funny s h it:laugh:
 
oldguy55 said:
I have no sympathy for the tattoo- and piercing-endowed who says she is afraid of needles.
Click to expand...

I cannot believe you guys keep saying this. Have you ever compared:
1) the size of the epidural needle and the tattoo needle?
2) how far each one of them go inside your body?
3) when women get an epidural, they are already in so much pain (I was ready to die) and all their body is aching. Yet, when you get a tattoo as far as I know, people are in a good mood and their bodies are not aching.
4) There is a sense of danger when you are getting an epidural because of its location (although its a needle, it feels like you are sticking a trunk of a tree inside someone's back). But when you are getting a tattoo you are putting it on flesh so there is no sense of danger.
However, I agree with you that piercing COULD be as painful as the epidural..
I just wanted you guys to know how women feel😉
 
rmbsstock said:
I cannot believe you guys keep saying this. Have you ever compared:
1) the size of the epidural needle and the tattoo needle?
2) how far each one of them go inside your body?
3) when women get an epidural, they are already in so much pain (I was ready to die) and all their body is aching. Yet, when you get a tattoo as far as I know, people are in a good mood and their bodies are not aching.
4) There is a sense of danger when you are getting an epidural because of its location (although its a needle, it feels like you are sticking a trunk of a tree inside someone's back). But when you are getting a tattoo you are putting it on flesh so there is no sense of danger.
However, I agree with you that piercing COULD be as painful as the epidural..
I just wanted you guys to know how women feel😉
Click to expand...


Do you have a tattoo? I do. It hurt like a mother.
 
Patients don't know the size of the needle (though sometimes I'd like to show it to them just to say, "see this? stop f'in moving before you cause it to get a kidney biopsy").

Tat's are purely cosmetic, and the person is willing to undergo pain for cometic purposes, I agree, there's no right to complain about either the burn of the lidocaine (which I have felt), or the pressure of the tuohy (which I admittedly haven't), which is done specifically to relieve pain.
 
ok, I do have a tat, up on my shoulder. hurt very much bad.:scared:

have had a spinal tap. they tried 5 times before it "went in" right. hurt very much bad, even on the 6th time. but at least that time they did not hit bone.:scared:

the pain was comparable. however, I do not ever ever ever want a needle inbetween the bones in my back again. (so no spinal tap, spinal or epidural, please) weird, but true.
 
killerleaf said:
o I do not ever ever ever want a needle inbetween the bones in my back again. (so no spinal tap, spinal or epidural, please) weird, but true.
Click to expand...

I suppose you had it in the ED? Spinals or epidurals are not supposed to hurt if you numb the skin with lidocaine
 
Unfortunately, "spinal taps" are usually done by Neurologists, radiologists or ER physicians and this is the main reason why many people who had them are afraid of spinal or epidural anesthesia.
In the hands of an experienced anesthesiologist a spinal or an epidural is pretty much painless.




killerleaf said:
ok, I do have a tat, up on my shoulder. hurt very much bad.:scared:

have had a spinal tap. they tried 5 times before it "went in" right. hurt very much bad, even on the 6th time. but at least that time they did not hit bone.:scared:

the pain was comparable. however, I do not ever ever ever want a needle inbetween the bones in my back again. (so no spinal tap, spinal or epidural, please) weird, but true.
Click to expand...
 
yes, it was done in the ER...and I can promise, it hurt like h*ll. The 6th time was much better, it was done by an anesthesiologist, who came in, felt my back, rolled his eyes, sat me up and bent me over, (as opposed to the other guy who had me roll on my side and then tried the 5 times,) they all jumped when they heard my back go "pop" when I sat up. It was 32 years ago, and I still can "feel" where it was even now in the winter time.

I know you guys are the bestest, and it would not be an experience like that. that is my head. the rest of me goes screaming away at the thought!!
 
oldguy55 said:
I have no sympathy for the tattoo- and piercing-endowed who says she is afraid of needles.
Click to expand...

I have sympathy for them. All they really know is that a great big needle is going to be drilled into their spines. This is different than someone repeatedly pricking their skin. Unless they're being jerks about it I give them the benefit of the doubt.

The drama sometimes annoys me, but so long as they hold still during the procedure, I let the verbal compassion and reassurance flow ...

Half the time I think the needle-phobia is an act, and what they really want is attention, validation, and the expression of sympathy. You know, chick stuff.
 
dhb said:
I believe you've never had an epidural
Click to expand...

What!!! are you kidding me?? I had three. The first one worked well. The second one was very bad because my right side was totally numb but I was still feeling my left side..and we could not fix it. The third one was good. BUT
1) you take many shots around the area to numb it. Although, the doctors where great and did them quickly, they were painful.
2) I could still feel the needle going in my back.

no I never had a tattoo but I was in the army and many of my friends got them. They said that they hurt depending on the location.
 
rmbsstock said:
1) you take many shots around the area to numb it. Although, the doctors where great and did them quickly, they were painful.
2) I could still feel the needle going in my back.
Click to expand...

1) No just one
2) It's called a local you can feel what's happening but it doesn't hurt

Anyway you're as crazy as your friend 🙄
 
dhb said:
1) No just one
2) It's called a local you can feel what's happening but it doesn't hurt

Anyway you're as crazy as your friend 🙄
Click to expand...

1) I remember my first one vividly. It was at least 4 shots in a circle. They went in and out very fast. Then, he put the epidural. The second one, the only thing that I remember is that half of me was moving and I can feel it and the other half was totally numb. It felt like I am an alien. It did not hurt as much as it felt weird . .
2) It doesn't hurt? Well, I have feelings and I felt a lot of pain...maybe you are a manly man...but I am a girly girl.
3) I ask you to be respective to me and my friend, especially that she is not here to defend herself.
 
Last edited:
rmbsstock said:
1) I remember my first one vividly. It was at least 4 shots in a circle. They went in and out very fast. Then, he put the epidural. .
2) It doesn't hurt? Well, I have feelings and I felt a lot of pain...maybe you are a manly man...but I am a girly girl.
3) I ask you to be respective to me and my friend, especially that she is not here to defend herself.
Click to expand...

1. There is no reason to do this. It may have been one needle pass with 4 separate injections (sq, dermal, deep, more sq?)? Was this in the US?
2. It hurts, until the lido works it's magic.
3. You earn respect, or not as the case may be.
 
IlDestriero said:
1. There is no reason to do this. It may have been one needle pass with 4 separate injections (sq, dermal, deep, more sq?)? Was this in the US?
2. It hurts, until the lido works it's magic.
3. You earn respect, or not as the case may be.
Click to expand...

1. Enterprise hospital AL .
2. 100% true
3. 100% true, and they need to stop talking about Eta since she is not here. I refuse to talk about others behind their backs in a negative way (or IMPLY negative things). The civil way is to discuss the issue in their presence (that's what they meant by my friend!). BUT, that is NOT what we are talking about here
 
rmbsstock said:
1) 4 shots in a circle. They went in and out very fast.
The second one, the only thing that I remember is that half of me was moving and I can feel it and the other half was totally numb. It felt like I am an alien. It did not hurt as much as it felt weird . .

Well, I have feelings and I felt a lot of pain

I ask you to be respective to me.
Click to expand...

:uhno: :bang:
 
dhb Do not do that to yourself (or hopefully me)
dhb said:
:uhno: :bang:
Click to expand...

WE are talking about the epidurals, and I said I had three. THE THREE HURT A LOT WHEN I GOT THE DAMN THINg in my back...that is why I said "Well, I have feelings and I felt a lot of pain".
I hardly ever cry from pain and I cried the three times. I also had a nurse "hugging me/holding me so I won't move". Now, you are making me wonder if people feel pain when they get the epidurals, or am I a weird case!!!!

After the epidural, the first and third times every thing was great because I went numb. However, the second time AFTER enduring the pain of the needle,
"The second one, the only thing that I remember is that half of me was moving and I can feel it and the other half was totally numb. It felt like I am an alien. It did not hurt as much as it felt weird . .
Sorry if I was confusing you. but this is my experience. You sounded that you do not believe me from the beginning, that is not my problem anymore.
 
killerleaf said:
ok, I do have a tat, up on my shoulder. hurt very much bad.:scared:

have had a spinal tap. they tried 5 times before it "went in" right. hurt very much bad, even on the 6th time. but at least that time they did not hit bone.:scared:

the pain was comparable. however, I do not ever ever ever want a needle inbetween the bones in my back again. (so no spinal tap, spinal or epidural, please) weird, but true.
Click to expand...

dhb said:
I suppose you had it in the ED? Spinals or epidurals are not supposed to hurt if you numb the skin with lidocaine
Click to expand...

Planktonmd said:
Unfortunately, "spinal taps" are usually done by Neurologists, radiologists or ER physicians and this is the main reason why many people who had them are afraid of spinal or epidural anesthesia.
In the hands of an experienced anesthesiologist a spinal or an epidural is pretty much painless.
Click to expand...

Unfortunately, I had a spinal tap done when I was about 11. Pediatrician did it to me. I cursed at him the entire time because of the pain. I was a kid who never opened his mouth -- EVER. At one point, it felt like I had a lightning bolt explode through one of my legs. Afterwards, my mother demanded I apologize to him. Ironic, but that's another thread altogether.

When I observed a pain doc for 2 weeks straight down here in FL, (when I reached out to him I didn't know he was a pain doc, welcome to regionals for two weeks), I'd say I saw him and his partner give about what, 100 epidurals? 120? Only 1 woman, a crack addict of a thing, was in significant pain. All fetal'd up when she left, was fine with some ginger ale and crackers about 3 mins s/p needle withdraw. So that makes 119 pain free out of 120 when done by an Anesthesiologist. A couple cervical. It's funny, this place didn't let a Spine Fellow Trained PM&R
doc give cervical epidurals, liability. That didn't make him happy. Interesting to see his technique differ from Anesthesiologist. By the end of the weeks I'd seen so many I thought I should give one or get one myself...!

As for the spinal that caught a nerve when done by my Pediatrician, I wonder when the last friggin' spinal he did before mine was...! Or since for that matter. 👎

D712
 
doctor712 said:
As for the spinal that caught a nerve when done by my Pediatrician, I wonder when the last friggin' spinal he did before mine was...! Or since for that matter. 👎

D712
Click to expand...

The peds residents at my institution do a fair number of spinal taps, and seem pretty decent at them. Don't know how many they do after they leave residency for private practice, though. Guess it depends if they spend time in the ER, have inpatient privileges, strictly office-based, etc.

Also, I think I might like DreamMachine's posts the most out of anybody. For whatever reason, they seem to capture my attention...
 
WholeLottaGame7 said:
The peds residents at my institution do a fair number of spinal taps, and seem pretty decent at them. Don't know how many they do after they leave residency for private practice, though. Guess it depends if they spend time in the ER, have inpatient privileges, strictly office-based, etc.

Also, I think I might like DreamMachine's posts the most out of anybody. For whatever reason, they seem to capture my attention...
Click to expand...

this guy was 40 when he did it. long outta residency.
 
You must log in or register to reply here.

Similar threads

L
Epidurals overnight for IOL
2
Replies
96
Views
5K
pgg
pgg
lobelsteve
Another Tiktok influencer back tattoo general anesthesia death
Replies
16
Views
3K
Twiggidy
Twiggidy
woopedazz
Surgeons vetoing thoracic epidurals
Replies
27
Views
2K
Lecithin5
L
pmichaelmd
Precedex for labor epidurals and spinals
Replies
22
Views
4K
nimbus
nimbus
N
Dosing spinals for C/S after Epidural
2
Replies
76
Views
5K
deleted1183938
D
Top