Is Toradol still used after a C section?

rn/writer, RN · Mar 23, 2009

On our PP unit, the section moms routinely come up from L&D on a Dilaudid PCA and IV Toradol with straight oxycodone for breakthrough (which we almost never have to use). Between the narc and the NSAID, pain is usually well managed.

If this doesn't work, it's usually the Dilaudid that is the problem, not the Toradol. Then we do as Elvish said and dc the PCA and switch to Percocets. My estimate is that about 10% of my patients either dislike the way the Dilaudid makes them feel, it causes nausea/vomiting, or it simply does not give proper relief. The Percocets prove more effective. After I get rid of the PCA, I still give IV Toradol during the first 24 hours (provided their platelets and renal hx are good). The anti-cramping, anti-inflammatory properties of the Toradol coupled with the Percs do wonders. Moms that would have had a horrible time even standing up can walk to the bathroom and care for their babies, including breastfeeding, with this effective combination.

IMO, Toradol is a really good med for immediate post-op pain when coupled with a PCA or oral narcotic. Alone, it is seriously inadequate. Seriously.

Bortaz, MSN, RN · Mar 23, 2009

I've had kidney stones a few times, and all I have to say is "God bless Toradol!"

Vito Andolini · Mar 23, 2009

I'm currently on a PP unit for my preceptorship and we give our moms toradol in 4 doses usually. The come down from L&D usually already having one dose and we give the remaining doses as needed with motrin and roxicet. The only thing with Toradol is that I've been told it takes a while for it to actually be effective and is probably why we give 4 doses of it..hope this helps :)

How long does it take to be effective?

My relative said she really did not have adequate pain relief post C Section for 2 entire days and nights and she was very careful to ask for pain med right on time q4h. Knowing it takes a while to get a PRN together, she asked at the 3.5 hour mark. The nurses probably had her labeled negatively as a result. She said the Percocet she was given starting on POD #3 helped more than the "demerol" she thought she was getting. But I doubt she got Demerol, even 20 years ago.

It was probably merely an NSAID, which I think is outrageous for someone who's been sliced open and who is expected to care for her rooming-in, BF'ing newborn. Most of the time, she was alone - no one there to pick up the babe and hand him to Mom, (to spare her the pain of having to lift 10# after surgery. No one to lift the babe back into the cradle - so she kept him right on her bed and, of course, got chided/scolded for that.

Why so stingy with a good old-fashioned opiate for a post-op patient?

BTW, I had no idea there was this much to discuss about what I thought was a simple question. Thanks to all for your most interesting input.

I just went back and read some of the entries I hadn't read and I see that I was not too far off the mark - that Toradol is good in combo with an opiate and on a regular basis, not making the patient ask for it PRN. Thanks to all of you.

I am angry that she was allowed to suffer. No nurse ever offered her anything for breakthrough pain, there was no PCA and no epidural. It sounds like the Toradol was IV but was just inadequate. Oh, well, she is ok and so is her daughter, who wants to be a nurse.

Jolie, BSN · Mar 23, 2009

I'm a little confused. Did your family member deliver a number of years ago?

If her baby is indeed 20 years old, then it is quite likely that mom received Demerol for post-op pain as she believes she did. Demerol was commonly given IM for post-C-section pain at that time. IV pain meds were rarely given on "regular" floors back then, and PCAs were not widely used.

I'm not trying to excuse poor pain management, especially since she vividly recalls it so many years later. Just trying to point out that practices have changed quite a bit in 20 years.