Greetings, fellow PACU nurses! Just wondering if any of you are using Vistaril in your practice (anesthesia postop orders)? What about Droperidol? In my facility, we use neither and have had good results when the anesthesia team uses prophylactic Zofran and Decadron (occasionally Reglan) intraoperatively. For rescue emetics, we use Phenergan (which we give IVPB in small doses - 6.25 to 12.5 mg).
Just curious what others are doing and how effective the treatment of PONV is. Thanks for your responses!
Dec 31, '06
We often give vistaril IM as needed, but usually we give it for severe pain along with IV narcotics. It seems to help. Usually zofran or dolasetron are given in the OR prophylactically, but if not given in OR we will give in PACU usually first with benadryl being our second choice for nausea. Phenergan is frequently ordered PRN but is farther down our list of nausea drugs due to its nasty side effects. Before all the black box warnings we gave droperidol frequently but rarely ever see it used now and if it is they need to be on telemetry for a certain number of hours afterwards.
Jan 14, '07
We use Kytril but are switching to Zofran soon. They use Decadron and Reglan too. Anzemet for pediatrics. Phenergan is non formulary now and was only to be given diluted through a central line.
Jan 29, '07
Hello: ai have seen zofran, reglan and decadron given pre-op in pts with a hx of post-op n&v. in the pacu, we use zofran quite regularly, and it seems to work well. I usually dilute with 8ccns and push. we also give vistaril im,but it is generally used in conjuntion with demerol for a potentiating effect of the narcotic, we also use it as a anti-anxiety med too sometimes. We have one doc that still orders droperiodol, it does have good sedative effects as well as anti-emetic effects. but i don't see it as often.
Jan 30, '07
I think it is all a matter of preference of the Anesthesiologist writing your post op orders. When I worked down town in NYC, they usually started with Zofran and then used compazine IM, choosing to use Vistaril when the patient had a high level of anxiety. If the Zofran and Compazine did not work then depending on the doctor that responded to the call that the patient still had hyperemesis, they may prescribe reglan or droperidol. I have been finding that they are shying away from the droperidol due to the black box warning that accompanies it. Now at the trauma center I do some per diem work in they use Zofran and Kytril primarily and very rarely Vistaril or Compazine. I have also one a rare ocassion seen them use reglan. It also depends on the hospital formulary as well.
Mar 24, '07
Zofran, Dex, Reglan, Pepcid, Benedryl, Scopolamine patch, rare visteril.
Mar 25, '07
Zofran, Phenergan, Anzemet, Reglan, scopolamine, droperidol, ativan. We try whatever until we find something that works.