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an appropriate pre-op medication

Nurses   (3,472 Views 14 Comments)
by GingerSue GingerSue (Member)

GingerSue has 20 years experience .

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is demerol an appropriate pre-op medicaton (or post-op analgesic) for someone who has a malfunctioning kidney?

Without knowing the functioning of the other kidney - demerol is metabolized to normeperidine which is dependent on the kidneys for excretion.

(and normeperidine accumulates, seizures can result)

Is demerol appropriate?

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6,487 Posts; 21,380 Profile Views

Yes because you would know the status of the other kidney. When one kidney has problems a very close eye is kept on the other one. It is even okay with two malfunctioning kidneys if it's a pre-op med because it's a one time dose.

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GingerSue has 20 years experience.

1,842 Posts; 28,338 Profile Views

what about demerol for post-op analgesic?

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pebbles has 17 years experience as a BSN, RN and specializes in Trauma acute surgery, surgical ICU, PACU.

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what about demerol for post-op analgesic?

Some studies have been done that show demerol is also not very effective as an analgesic. Add that to the concerns about normeperidine build-up, and many places are phasing out using it for analgesia beyone one or two doses.

My patients have also told me that demerol doesn't kill the pain; It gives them a high so that they "don't care about the pain any more". (Maybe another reason why Demerol is so much in demand amongst the addicted/ drug dependent population....)

IMO, if someone's allergic to other analgesics, I'll use demerol if I have to. But I'd rather give them something safer and that works!

In the PACU in my hospital, they use demerol for post-op shivering.

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My patients have also told me that demerol doesn't kill the pain; It gives them a high so that they "don't care about the pain any more".

I've heard the same thing

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lsyorke is a RN and specializes in Med-Surg, Wound Care.

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Demerol isn't even formulary in my hospital anymore. It's a lousy analgesic. We stopped using it years ago.

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We only use it post-op for rigors. I haven't seen it used as a pre-op med in over a decade. I usually see Versed just as they're wheeling the pt out the doors.

For post-op analgesia? Never.

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267 Posts; 3,165 Profile Views

I still see Demerol and morphine in PCA pumps for post-op as well as IV push in the ER.

Isn't it interesting how practice varies depending on what part of the country you live in. In my hosp. the only units that even have Demerol are mine (pre-op), ICU and PACU. It's not kept in the Pyxis in any other dept.

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HenryH0 has 2 years experience.

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I work on a surgery floor and the doctors are great they usually prescribe different analgesics to try like prescribing T3's, demerol and morphine until the patients find one that works for them and then the nurses use the one that works for the patient

we also make sure to teach the patient to ask for the analgesic that works for them

Surprisingly the most effective analgesic that I have found is toradol

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