Demerol PCA Pumps

[walk2]

We recently had a post -op patient that was on a Demeoral PCA pump that had a focalized seizure and remained unconscious for about 4 hours afterwards. We heard that this is becoming a common finding with the use of Demoral PCA pumps any thoughts or comments?

[jmgrn65, RN]

I am not sure of that particular case, But Demerol is being taken out of many hospitals formulary. We stopped using it in out facility.

[Mulan]

Had a patient a few years ago that had a seizure and it was thought to be due to the demerol pca.

[barbyann]

Yup, no more Demerol around here.

[lpnflorida, LPN]

Demerol has not been used in our facility for a few years now. Too many possible complications with the use of demerol. Many other narcotic pain relievers which work as well, and with less respiratory depression, nausea with vomiting, illeus, to mention a few possibilities.

[sicushells, RN]

our post op patients are really only recieving demerol in the pacu to stop shivering, otherwise we stay away from it for the reasons listed above.

[wtbcrna, MSN, DNP, CRNA]

The probelm is in the metabolite normeperidine. Here is good overview on the subject. http://www.medscape.com/viewarticle/481374_3

[RedCell]

I would like to know what kind of practitioner wrote the order for the meperidine PCA. My guess.....an orthopod.

[azhiker96, BSN, RN]

The only PCA meds we use are morphine, hydromorphone, and sublimaze. Meperidine is used in PACU for shivering or pain but typically not on the floors due to the metabolites.

[Roy Fokker, BSN, RN]

Wow - Demerol PCA? Interesting!

We don't use Demerol in our institution - OR, ER or otherwise.

cheers,

[blondy2061h, MSN, RN]

We only use demerol for rigors. Our PCAs are morphine, dilaudid, methadone, or fentanyl.