We have not used Demerol in YEARS on our unit, for any patient, whether in labor/delivery or post-op.
Stadol, 1-2 mg IVP every 2 hours.
Nubain, 5-20 mg IVP every 2-4 hours.
For Therapeutic rest in prodromal or very early labor, we often give 10 mg Morphine, with 12.5-25 mg Phenergan IM. This often works great to get mom comfy enough to either rest til she goes into active labor, or conks out prodromal discomfort for hours. I am glad our docs allow this-----I hate to see them so uncomfortable and do nothing for them.
We are also allowed to give Phenergan, IM only, for nausea and in some cases, pain control, but never IV due to its potential vessicant problems. I do NOT like giving Phenergan in labor patients at all. Makes them way too sleepy and dopey, more so than Stadol or Nubain, in my experience. If patients are nauseated, we are allowed to give Anzemet, 12.5 mg IVP and it works!
Regarding Fentanyl: I used to use Fentanyl, IVP, 25-100mcg every 2-4 hours where I used to work in Oklahoma. Used to also have to have patient on pulse ox monitor when Fentanyl was in use, as I recall......
I have never seen Demerol used in labor in 8 years' L/D nursing, however, I do remember them giving a shot of it in my rear when I was in labor w/my son 13 years ago. It was totally useless. I wound up begging for an epidural at 8cm.
From what I have learned, Demerol is no longer recommended in L/D (and many other units) due to its capability to lower the seizure threshold in some people. Like I said, I have not even seen that drug stocked where I work in years.