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Discussion

Dilaudid and bp

I had surgery last Monday and was on a Dilaudid pca for the first day and a half or so. It worked great for the pain, but gave me a pretty funny story that I thought I'd share, mostly because I have a question that comes out of it.

So they wheel me into my room and someone handed me the trigger and said, "Now don't you be shy about hitting that button if you need it. It's set to recharge q10m." So, being the biddable pt that I am, I resurface every 10 minutes to pop that doohicky. Sweet, sweet relief.

I had a bp cuff on for the first 24h at least, and at one point one of the nurses came in to see the tracking and said, "Yeah, you're gonna want to let up on that pump a little bit. Your pressure is down to 77/46." :eek: No wonder I was so tired! :lol2:

So here's my question: is this something about narcotics in general? Dilaudid in particular? or am I just a cheap date? Do pressures usually bottom out that way on pain meds? FWIW, I'm normally in the 110/60 range, give or take. I've been on other pain meds for periods, though not IV, and maybe not as strong as Dilaudid, so I was really surprised by my rxn.

Is it odd to say that I vastly prefer Toradol to Dilaudid? I'd make a lousy seeker. :bugeyes:

Oh, and one of the CNAs was astonished that my bp was exactly the same at two different readings. I know that's probably not common, but she was REALLY SURPRISED. Then again, I shocked one young man by asking for prune juice, so who all knows what goes on in med-surg here.

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    BP dropping on narcotic virgins...not so uncommon. I probably would have gotten an order to decrease your dose or taken away the button before your BP got into the 70s. Hope your recovery goes well!

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    Hey, now, let's not use nasty names! IIRC, it was a dose of .3 (I'm assuming mg) q10m, then q30. Spacing it out helped a bit.

    Now I'm down to ibuprofen once or twice a day for the sciatica I've rustled up. Yay me!

    Thanks! I'm getting antsy to drive, man. Cabin fever is hitting hard, and with three little kids.... woof.

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    Toradol is the best med ever (not for everyone), but the relief some people get from it without that "loopy" feeling is awesome.

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    Toradol is the best med ever (not for everyone), but the relief some people get from it without that "loopy" feeling is awesome.

    Just make sure renal function is OK.

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    Toradol is the best med ever (not for everyone), but the relief some people get from it without that "loopy" feeling is awesome.

    The nurse who brought me the first dose said, "Okay, this is Toradol, and the best thing about it is everything." Too right.

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    toradol is so great for the deep bone pain! narcotics+npo status/dehydration can drive down your bp def! feel better- hope your kids take it easy on ya!

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    I usually have 2-3 patients a night on a Dilaudid PCA pump. You are definitely in the minority for the blood pressure bottoming out. A lot of our post-ops are getting it q8m and generally don't have a problem.

    My guess was that you might have been using it more than you needed. Most of my patients I see bottom out are definitely push happy on that button.

    We don't have cuffs on our patients, but we do check the BP q1h x 6 and then q2h after that until the pca is discontinued then q4h after that. The patients are always on a continuous plusox though.

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    I love Toradol! I had cholecystitis and was given it and it was the best experience of my life! I'm a cheap date, I know! Actually, I was in a car accident and bashed my face off of the steering wheel and was given a little morphine for the pain... I felt like I was flying though space on a merry-go-round...

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    Usually when I see my patients bp drop it's usually because they're dry not the dilaudid. If after a liter bolus or two it doesn't start rising then I'll suggest slowing down (or play hide the button) unless they want to buy themselves a one way ticket to the unit.

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    Opiates can cause release of large quantities of histamine which are one of the mediators of hypotension. Hypotension with opiates is not an uncommon problem.

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    I was edematous, they were pumping so much fluid into me. Kinda glad I had the foley, actually. lol

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    Opiates can cause release of large quantities of histamine which are one of the mediators of hypotension. Hypotension with opiates is not an uncommon problem.

    Huh. Do you suppose that having crazy allergic rxn to a few things in my life might predispose me to producing lots of histamines for other reasons?

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