C Section Post-Op Rx

[Kooky Korky]

Is Toradol still given for post-op C Sections? Then switch to p.o. Percocet on POD 3 or 4?

Thanks.

[klone, MSN, RN]

It's been more than 30 years since this all happened and I still think about writing a letter to the ##$#%% who are in power at that stinking facility.

Wait, this was something that happened 30 YEARS AGO? Time to build a bridge.

And yes, the statute of limitations expired 12 years ago.

[wtbcrna, MSN, DNP, CRNA]

One additional thing that I haven't seen listed is Transversus Abdomins Plane (TAP) blocks. The TAP block will help with the somatic pain that the neuraxial morphine/duramorph does not usually help with. Transversus abdominis plane block provides postoperative analgesic effects after cesarean section: additional analgesia to epidural morphine alone. - PubMed - NCBI

The push for pain control now is to use a multi-modal method while decreasing the use of opioids. 30mg of toradol, for example, is an NSAID but is the equilavent for pain relief as giving 10mg of morphine.

There are multiple ways of providing pain relief after c-sections, but most incorporate neuraxial opioids, nsaids, acetaminophen, and IV/oral opioids. The regimen changes from hospital to hospital with a lot of OB providers just ordering what they were taught during residency.

[Horseshoe, BSN, RN]

It's been more than 30 years since this all happened and I still think about writing a letter to the ##$#%% who are in power at that stinking facility.

You want to write a hospital about an incident that occurred 30 years ago?! Don't you think it's highly likely that protocols have changed multiple times in that unit over a period of 3 decades?

The more I think about this, the more I know I need to inform the hospital, get her to get a lawyer, whatever. It's probably been way too long ago for any legal action, but even an acknowledgement would help, I think. Anyway, it was at one of those, how do you call it, Magnet outfits!

I can't imagine a lawyer wanting anything to do with this 30 years after the fact.

[3ringnursing, BSN]

I am a Postpartum nurse and my c/s moms take Toradol or Ofirmev prn with either their Dilaudid PCA or Fentanyl PCE for 24hrs postop. From POD 1-3 when their pumps are already d/c'd, they are switched to Percocet and Motrin. And they will take that for the remaining of their stay and will go home on that rx. I know every facility is different, that's what happens on mine.

Nice to hear pain management has improved in the past 23+ years since I had a C-section.

I remember it was so painful post-op that I didn't even want to move (plus, I thought my incision was going to dehisce, spilling my intestines onto the bed). I got 2 PO percocet in PACU, which sadly did very little for a belly that had experienced what mine did. No more babies for me after that experience.

[applewhitern, BSN, RN]

I had two C-sections years ago, and all I got was Tylenol. That was back during the "natural childbirth" craze, and I still resent it to this day. I got a major staph infection from the first surgery, and was in the hospital for 2 weeks with 103 fevers. Like I said, here it is years later and I'm still ticked that they let me hurt like they did! Thanks for letting me vent.