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Second Opinions > Use of Demerol for Post-Op Pain Control

Use of Demerol for Post-Op Pain Control

Is anyone still using Demerol for post-op pain control in PACU, or is it only used for shivering?

Started by: Maureen Darling (Other) at January 27, 2011 (8:39 am)

Comments and Responses

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In our facility, we only use demerol (50mg) for shivering but always use it in combination with promethazine (25mg) to assist with nausea. If you use demerol, be prepared to have the patient in your facility (PACU)for additional time than you really need to. We now use fentanyl (25mcg) for post-op pain which is shorter acting but just as effective.

Jay Shorr (Administrator/Director/Manager/Owner/Exec. Officer) at June 8, 2011 (6:24 pm)

We use it for patients that come out of the OR shivering & for IM pain control.

Kathy Groff (Director, Surgical Services/Director of Nursing) at June 8, 2011 (12:47 pm)

we use demerol for emergence delirium with our pediatric patients and have excellent results with it. we do use it for shivers also.

Carol S. (Other) at February 23, 2011 (1:59 pm)

We have used it mainly for shivering. One of our MD providers likes to use it in the OR. We have recently had problems getting it due to national back order.

K. Merrill (Director, Surgical Services/Director of Nursing) at February 11, 2011 (11:04 am)

We only use it for post op shivering. We use Dilaudid for post op pain.

S. Garza (Director, Surgical Services/Director of Nursing) at February 8, 2011 (9:37 am)

We use Demerol in PACU for post -op pain we start titating slowly I.V. for pain 10/10. within few minutes patient is getting relieved then we follow I.M. Injection with the low prescibed dose by anesthesia or phycian. We also use Morphine and titrate slowly I.V. Hydrocodone or tylenol #3 for minor procedures.
M. Gutierre3z R.N. Dir. Surgival services MCHD

Maria Gutierrez (Director, Surgical Services/Director of Nursing) at February 6, 2011 (10:06 am)

The issues with demerol involve long term use and not one or two doses as would be used in the recovery room at an ASC. The main advantage over demerol in this setting is its faster onset of effect. This is particularly valuable in pediatric patients. Our RR is much quieter as we have gotten most of our anesthesiologists to use this drug rather than morphine. Pain control is faster and I think this results in faster discharge times. We also encourage our anesthesiologists to administer morphine or demerol in the OR for those patients with painful procedures that they know will require pain medicine in the RR. This too, helps reduce discharge time. Overall, we use much more demerol than morphine. If used correctly, it is a good drug and our RR nurses prefer it over morphine.

John Bentley (Medical Director/Chief Surgeon) at February 3, 2011 (12:36 pm)

Demerol got a bad rap for it's metabolites and affects on renal function which was linked to longer term use. We removed it from our PCA pumps quite a while ago. However, there has also been a recent push in wanting to take it off formulary. The anesthesia department keeps it as one of the tools in the box and is used when appropriate.

Timothy F. (Anesthesiologist/Nurse Anesthetist) at February 1, 2011 (7:41 am)

I work in an ASC and we still have demerol in stock for pain control and we continue to use it for the management of shivers. What we want to know is why people are getting away from the use of demerol?

D. Brown (Other) at January 31, 2011 (12:45 pm) [last edited on January 31, 2011 (12:45 pm)]

We use meperidine for shivering in our PACU. Also used for post operative pain control in patients tolerate to other analgesics.

K. Lewis (Medical Director/Chief Surgeon) at January 29, 2011 (10:47 pm)

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