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." No wonder I was so tired!
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.
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.
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?
My husband did that in the ER with his kidney stone. He got a couple doses of Dilauded, dropped his BP to 80s/40s (previously 120/72), HR in the 40s, and O2 in the 80s. I was like um... I know he's a big guy (6'1" 240lbs) but he's never had IV narcotics... I was certainly glad I was a nurse and there.
No wonder I was so tired! 
cmonkey
613 Posts
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?