Demerol is passe?? Can anyone fill me in?

  1. 0
    Hi, not a pain specialist, but I have been hearing demerol being criticized as ineffective for pain relief a lot lately. Where is this research coming from? Is there a resource anyone can recomened for learning more about this?
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  5. 0
    I know one of the reasons that demerol has fallen out of favor is that it accumulates and can cause seizures. Don't have any references though.
  6. 0
    the elderly are particularly sensitive to having altered mental status when on Demerol. I believe the thinking is that since other drugs can effectively treat pain without psychotropic side effects, we should not use Demerol.
  7. 0
    Now that you mention it, I can't remember the last time I had a Demerol order for pain. It's generally been Morphine or Dilaudid that's being ordered on our med-surg unit.
  8. 0
    Demerol does exaserbate siezures and cause tremors after prolonged use however I feel Demerol is getting a bad rap overall because this the drug of choice for many so-called drugseekers but it is also very effective for migraines (when used as strictly pain control...not abortive agent) and other pain when combined with say Torodol or other nsaids. Its also a good second choice if one is allergic to morphine since Fentanyl is a short acting. (according to my pcp) That's my .02 cents.

    AAARGH! Where's Dave when you need him?
  9. 0
    Demerol (meperidine) when metabolized produces noremeperidine which lowers the seizure threshhold. Lately I've used small (25mg) IVP doses in patients to control shivering.
  10. 0
    Quote from rollingstone
    Demerol (meperidine) when metabolized produces noremeperidine which lowers the seizure threshhold. Lately I've used small (25mg) IVP doses in patients to control shivering.
    Yeah, there's usually an order for Demerol for fresh post-op pts during recovery for shivering.
  11. 0
    When I was fresh post-op for a thyroidectomy, I remember being in #10 pain when I awoke. I asked the nurse "What did you give me, Narcan?". She said "I have given you a 100 mgs. of Demerol!" I told her that Demerol didn't kill my pain. She called the doctor, got the order for morphine and that did the job. Also, Toradol works better for me then Demerol.

    Demerol can be a cerebral irritant esp. in certain patient populations.


    http://www3.us.elsevierhealth.com/WOW/op024.html


    Quote from nurse_robin
    Yeah, there's usually an order for Demerol for fresh post-op pts during recovery for shivering.
  12. 0
    A bit off track but a question...

    Demerol (meperidine) when metabolized produces noremeperidine which lowers the seizure threshhold. Lately I've used small (25mg) IVP doses in patients to control shivering.
    In what circumstance would you want to control shivering post op? I was taught shivering is a normal and necessary physiologic response resulting from being in a cool OR?
  13. 2
    IMUSTBECRAZY, you ask a good question. Shivering post-op actually leads to heat loss, increased risk for cardiac arrythmias, and increased pain. After surgery, one of our key goals is to maintain core and surface body temps. If a patient is hypothermic they are at risk for more post-op complications including taking the oxygen away from cells(shivering uses oxygen) and acidosis.
    mew808 and


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