why is dilaudid the most common IV pain control method. Just wondering why i dont see more morphine. Why isnt demerol used very often? In my experience patients do not respond very well to morphine....
Demerol has issues with toxic metabolites, plus a nasty addiction profile. Many places have phased it out as pain control, although our PACU still has it for post-op shivering. I can only recall giving Demerol once or twice, it was effective, but there are better options.
The classic Dilaudid vs. Morphine debate boils down to potency. Remember, 1mg of Dilaudid is equivalent to 7mg of Morphine, so the buzz is going to be "better". More bang for your buck so to speak. That's why the seekers are always asking for Dilaudid instead of Morphine. It does work well, if a little short-lived.
With the hospital I'm at now we primarily use Dilaudid, occasionally I'll give morphine but it's rare. When I was working in New Orleans it was almost always the phenegran/morphine combo simply because of the seeker issue. And I can probably count on one hand the amount of times I've given demerol. And actually the first time I was ever ordered to give demerol was an awful experience that almost got me fired, and ended with someone else administering the medication because I refused, the patient ended up having to be given Narcan, and me being right after all.
The hospital I am doing my clinicals at uses primarily Dilaudid.
On a personal note, I can't have morphine (hives at the injection site) or phenergan (makes me freak out) or toradol (anaphlaxis)...so when the lovely kidney stones (of which I've had 8) rear their head, 1mg of Dilaudid usually does the trick to ease the pain, usually combined with 25mg of Benadryl.