Pain meds and + drug use

[L&DTami]

Hey all- I am sort of new to L&D and i have a queation. The other night my pt was a pt who had late prenatal care and was + for opiates in her urine at her first visit in October. She comes in to deliver, of course in pain. I get a Stadol order, which DOES NOT EVEN PHASE HER!!!! I check her and she is 4cms, so the attending says go ahead on the Epidural. The Epidural does NADA! At this point it is 7 A and I call anesthesia, give report, and go so I don't know what happens next.

My question is this- I know if she is still on drugs the stadol will not be effective,or as effective, but does it work the same with the epidural?

Would appreciate any answers because when we get pts like this in I am usually the one who is assigned.

[mother/babyRN, RN]

Thanks Mark..I knew that but after 2 12 hour night shifts and being so tired, didn't want to get it wrong..You know how it goes when the place is wild......Hopefully, this fact is shared when people take neonatal resucitation.....It is a big deal around here and we use stadol all the time too, which is why we are so aware of it...Our chief OB makes it known to all the other OBs, who are often not aware of it....

[mark_LD_RN]

I find its a little known fact, i have had docs order nubain within an hour of giving demerol. I politely point out that is not a good idea!

it's been hectic here also,we have been full and had to move several patients from the LDRP rooms to out overflow PP hall.:)