Demerol, YUCK!

Nurses General Nursing

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What is the love affair that PMD's and even some general surgeons have with demerol confused.gif. On our ortho floor is we are not even giving our doctors the option to use it in the new pain management protocol. It doesn't work, gives elderly people narcotic induced psychosis with very little amounts and ust isn't a justifable medication unless the patien is allergic to dilaudid or ms04. Is this just and issue in our area or is this nation/world wide?

Zee!!!! I love the projectile vomiting thing, I can not stop laughing. I think I will be using that in the future.

Jill

Zee!!!! I love the projectile vomiting thing, I can not stop laughing. I think I will be using that in the future.

Jill

Excellent, a worthy subject for a change.

Before I get started, I have never personally taken Demerol or Fentanyl (or even percocet really), but I have sedated a lot of patients for endoscopic procedures.

I despise Demerol. I hear repeatedly from folks that have had it that they still "feel" pain, they are just powerless to do anything about the pain they are experiencing. The only thing I know of Demerol has going for it is that it is relatively cheap.

In combination with Versed, concious sedation is relatively easy, but lets see, the patient is still feeling pain and can't do anything about it, but because of the Versed they can not remember later they were in pain. To me that sounds like "pain control" maybe, but definitely not "controlled pain."

I do like sedating with IV Fentanyl just fine. It seems to me it is a lot smoother induction (takes a little longer than Demerol), and a smoother recovery too. Intra-procedure, once I got a good handle on dosing and onset timing, my patients seem, to me, to be more relaxed during their procedures. The folowing is anecdotal, but I think I see fewer EKG changes too.

When it is my turn for a colonoscopy, I am going some place that uses Fentanyl.

Excellent, a worthy subject for a change.

Before I get started, I have never personally taken Demerol or Fentanyl (or even percocet really), but I have sedated a lot of patients for endoscopic procedures.

I despise Demerol. I hear repeatedly from folks that have had it that they still "feel" pain, they are just powerless to do anything about the pain they are experiencing. The only thing I know of Demerol has going for it is that it is relatively cheap.

In combination with Versed, concious sedation is relatively easy, but lets see, the patient is still feeling pain and can't do anything about it, but because of the Versed they can not remember later they were in pain. To me that sounds like "pain control" maybe, but definitely not "controlled pain."

I do like sedating with IV Fentanyl just fine. It seems to me it is a lot smoother induction (takes a little longer than Demerol), and a smoother recovery too. Intra-procedure, once I got a good handle on dosing and onset timing, my patients seem, to me, to be more relaxed during their procedures. The folowing is anecdotal, but I think I see fewer EKG changes too.

When it is my turn for a colonoscopy, I am going some place that uses Fentanyl.

I just have to unload again. This is about pain control. I am still haunted by a situation when I worked adult psych. There was a geriatric psych unit next door to us that was overflowing. We accepted this elderly lady (Alzheimer's). She would cry and grab me and beg for pain relief. I called MD in middle of night one time (Oops!) Most of the nurses felt she was drug seeking (we were all used to drug seekers on our unit). I really felt she was in pain. She was 83 years old and I worked the night shift and she would cry and beg for something for pain. We had only been giving her Tylenol and I had told charge nurse to talk to MD "in daytime hours" - that I really felt patient was in real pain. After about a week of moaning and groaning, she had tests done and had bone cancer and transferred to another unit. All I know is this, if I ever reach age 83 y/o I want a doctor who will give me whatever I need for pain. Are we really worried about addiction at age 83?

I just have to unload again. This is about pain control. I am still haunted by a situation when I worked adult psych. There was a geriatric psych unit next door to us that was overflowing. We accepted this elderly lady (Alzheimer's). She would cry and grab me and beg for pain relief. I called MD in middle of night one time (Oops!) Most of the nurses felt she was drug seeking (we were all used to drug seekers on our unit). I really felt she was in pain. She was 83 years old and I worked the night shift and she would cry and beg for something for pain. We had only been giving her Tylenol and I had told charge nurse to talk to MD "in daytime hours" - that I really felt patient was in real pain. After about a week of moaning and groaning, she had tests done and had bone cancer and transferred to another unit. All I know is this, if I ever reach age 83 y/o I want a doctor who will give me whatever I need for pain. Are we really worried about addiction at age 83?

Specializes in Critical Care,Recovery, ED.

Much prefer to use Fentanyl. Demerol can be nasty at times, but does have some limited uses. Only problem is the Fentanyl is becoming scarce. Seems one major (?the only) manufacturer is no longer going to produce Fentanyl as they can't make enough money on it.

Specializes in Critical Care,Recovery, ED.

Much prefer to use Fentanyl. Demerol can be nasty at times, but does have some limited uses. Only problem is the Fentanyl is becoming scarce. Seems one major (?the only) manufacturer is no longer going to produce Fentanyl as they can't make enough money on it.

nurse jane, that is TERRIBLE! That poor woman shouldn't have had to suffer like that and I agree with you that we shouldn't worry about addiction in an 83 year old or in any age for that matter. Study after study has shown the adiction rates for people getting narcotics for pain relief in a medical settin is less than 1%. But we continually force people to stay in pain because we don't want them to turn into addicts.

We use meperedine ALL the time, I think because it's cheaper than ms04. I don't think we give our patients proper pain relief anyways seeing as they're all a bunch of "drug seekers" (I mean, they must be lying, why would you feel pain after having your abdomen cut open, or your hip replaced?).

nurse jane, that is TERRIBLE! That poor woman shouldn't have had to suffer like that and I agree with you that we shouldn't worry about addiction in an 83 year old or in any age for that matter. Study after study has shown the adiction rates for people getting narcotics for pain relief in a medical settin is less than 1%. But we continually force people to stay in pain because we don't want them to turn into addicts.

We use meperedine ALL the time, I think because it's cheaper than ms04. I don't think we give our patients proper pain relief anyways seeing as they're all a bunch of "drug seekers" (I mean, they must be lying, why would you feel pain after having your abdomen cut open, or your hip replaced?).

Originally posted by nursejanedough:

I just have to unload again. This is about pain control. I am still haunted by a situation when I worked adult psych. There was a geriatric psych unit next door to us that was overflowing. We accepted this elderly lady (Alzheimer's). She would cry and grab me and beg for pain relief. I called MD in middle of night one time (Oops!) Most of the nurses felt she was drug seeking (we were all used to drug seekers on our unit). I really felt she was in pain. She was 83 years old and I worked the night shift and she would cry and beg for something for pain. We had only been giving her Tylenol and I had told charge nurse to talk to MD "in daytime hours" - that I really felt patient was in real pain. After about a week of moaning and groaning, she had tests done and had bone cancer and transferred to another unit. All I know is this, if I ever reach age 83 y/o I want a doctor who will give me whatever I need for pain. Are we really worried about addiction at age 83?

THANK YOU! YES I BELIEVE THAT DEMEROL IS MISUSED AND ABUSED. I WORK IN A URGENT CARE AND I SEE THE ABUSE WHEN THESE PT.COME IN WITH SO CALLED "MIGRAINES" AND WHAT DOES THE DR.TELL US TO GIVE 100 ML DEMEROL AND WHAT IS SO FUNNY THESE PT. ARE HAPPY AS CLAMS WALKING OUT OF THE PLACE. WE HAVE COUGHT 1 LADY AFTER TELLING US THAT THEY HAVE A RIDE HOME GET INTO THEIR CAR AND DRIVE OFF, WE CALLED THE POLICE AND SHE WAS ARRESTED YEH!!!SHE EVEN HAD HER 3 YEAR OLD DAUGHTER IN THE CAR WITH HER AT THE TIME. SHE GOT THE GIRL TAKEN AWAY WE FOUND OUT THANK GOD BUT SHE GOT HER BACK AFTER GOING INTO REHAB.NOW THAT IS THE BAD THING ABOUT DEMEROL. I JUST WISH THAT MY FATHERS DR. WOULD HAVE GIVEN HIM DEMEROL WHEN HE WAS DYING OF LUNG CANCER ALL THEY GAVE HIM WAS TYLENOL #3. WHAT A JOKE THEY SAID THEY DIDN'T WANT HIM ADDICTED HE WAS DYING THE TYLENOL 3 JUST GOT HIM SO CONSTIPATED THAT HE WOULD CALL ME UP CRYING. WHO CARES ABOUT ADDICTION WHEN YOU ARE DYING. SO I THINK THERE IS A PLACE FOR THAT MED. BUT I ALSO THINK THERE IS ALOT OF ABUSE WITH IT TOO.

THANKS KARENCCMA

Originally posted by nursejanedough:

I just have to unload again. This is about pain control. I am still haunted by a situation when I worked adult psych. There was a geriatric psych unit next door to us that was overflowing. We accepted this elderly lady (Alzheimer's). She would cry and grab me and beg for pain relief. I called MD in middle of night one time (Oops!) Most of the nurses felt she was drug seeking (we were all used to drug seekers on our unit). I really felt she was in pain. She was 83 years old and I worked the night shift and she would cry and beg for something for pain. We had only been giving her Tylenol and I had told charge nurse to talk to MD "in daytime hours" - that I really felt patient was in real pain. After about a week of moaning and groaning, she had tests done and had bone cancer and transferred to another unit. All I know is this, if I ever reach age 83 y/o I want a doctor who will give me whatever I need for pain. Are we really worried about addiction at age 83?

THANK YOU! YES I BELIEVE THAT DEMEROL IS MISUSED AND ABUSED. I WORK IN A URGENT CARE AND I SEE THE ABUSE WHEN THESE PT.COME IN WITH SO CALLED "MIGRAINES" AND WHAT DOES THE DR.TELL US TO GIVE 100 ML DEMEROL AND WHAT IS SO FUNNY THESE PT. ARE HAPPY AS CLAMS WALKING OUT OF THE PLACE. WE HAVE COUGHT 1 LADY AFTER TELLING US THAT THEY HAVE A RIDE HOME GET INTO THEIR CAR AND DRIVE OFF, WE CALLED THE POLICE AND SHE WAS ARRESTED YEH!!!SHE EVEN HAD HER 3 YEAR OLD DAUGHTER IN THE CAR WITH HER AT THE TIME. SHE GOT THE GIRL TAKEN AWAY WE FOUND OUT THANK GOD BUT SHE GOT HER BACK AFTER GOING INTO REHAB.NOW THAT IS THE BAD THING ABOUT DEMEROL. I JUST WISH THAT MY FATHERS DR. WOULD HAVE GIVEN HIM DEMEROL WHEN HE WAS DYING OF LUNG CANCER ALL THEY GAVE HIM WAS TYLENOL #3. WHAT A JOKE THEY SAID THEY DIDN'T WANT HIM ADDICTED HE WAS DYING THE TYLENOL 3 JUST GOT HIM SO CONSTIPATED THAT HE WOULD CALL ME UP CRYING. WHO CARES ABOUT ADDICTION WHEN YOU ARE DYING. SO I THINK THERE IS A PLACE FOR THAT MED. BUT I ALSO THINK THERE IS ALOT OF ABUSE WITH IT TOO.

THANKS KARENCCMA

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