I work on a med-surg floor and we mostly do gynecological surgeries, though we have others too. It seems most people coming back have nausea/vomiting within a couple hours. Most of our post op standing orders call for Phenergren IV, PO, or PR , Onadestron or Reglan. Reglan is useless if they are not eating. Zofran has little effect it seems and Phenergren zonks them out so bad I HATE giving it. They are already drowsy, on PCA's of some sort and had spinals.
What do you all do? What can we suggest to the MD's? Vistaril is seldom if ever used. One older RN told me once of some drug they gave that worked wonders and was very inexpensive, but I can't think of it. (maybe droperidol? or Tigan? ) She did not know why they don't give it anymore, but said they still have it in the pharmacy. I have never used either of them.
When I had surgery the anesthesists always gave me something and I never had post op nausea.
12.5 of dilaudid not only soothes N/V, it also stops that post op "shiver" and keeps your post op patient comfortable but arousable. Ask your anesthetist.
do you mean 12.5 mg of DEMEROL? I have worked in PACU and SICU and have never given more than 1-2 mg of dilaudid at any given time. LOL
I usually go for the anzemet but since now the formulary has changed to zofran I go straight for the reglan with good results. I hate phenergan since it sedates too much. Other than that we use zofran. I just like reglan better. I have used inapsine (droperidol) and it worked really well, but since I have since left that hospital it is no longer on formulary anywhrere. That is just my opinion.
I work on a med-surg floor and we mostly do gynecological surgeries, though we have others too. It seems most people coming back have nausea/vomiting within a couple hours. Most of our post op standing orders call for Phenergren IV, PO, or PR , Onadestron or Reglan. Reglan is useless if they are not eating. Zofran has little effect it seems and Phenergren zonks them out so bad I HATE giving it. They are already drowsy, on PCA's of some sort and had spinals.
What do you all do? What can we suggest to the MD's? Vistaril is seldom if ever used. One older RN told me once of some drug they gave that worked wonders and was very inexpensive, but I can't think of it. (maybe droperidol? or Tigan? ) She did not know why they don't give it anymore, but said they still have it in the pharmacy. I have never used either of them.
When I had surgery the anesthesists always gave me something and I never had post op nausea.
So, whats your opinion?
One my floor we use either compazine, palonosetron (i like this one alot), and when all else fails we try Ativan too! I have found the Zofran ODT works too!
From my own personal experience, I liked phenergan. When I had surgery, the nurse gave me phenergan IM and I never had any nausea whatsoever. My arm hurt for about 4 weeks, but I guess that's better than puking my guts out when I was in extreme pain.
Specializes in CVICU, CCU, MICU, SICU, Transplant.
Phenergan works pretty well on my pts, but like everyone says, it hurts like crazy (plus zonks them out). However I try to avoid it on my elderly pts who might be prone to confusion. I usually give it IV. However it is important to have a really good-working IV, and to push it slowly, since it can cause realy nasty phlebitis.
12.5 of dilaudid not only soothes N/V, it also stops that post op "shiver" and keeps your post op patient comfortable but arousable. Ask your anesthetist.
that seems like a pretty big dose of dilaudid but we do use demerol 12.5mg to stop shivering...
Specializes in ER, Outpatient PACU and School Nursing.
we only use demoral for post op shivers. I dont think they even make Tigan supp anymore..
zofran is our #1 choice where I work and if there is a issue with a patient- they premedicate in preop. phenergan is not used that much and if it is we do like 6.25mg. we have had ENT cases where we do put scopolamine patches on if the person has a big issue with postop n/v.That has to be done prior also. I have seen a few times with severe postop N/V- our anesthesiologist have given a few cc's of diprovan in pacu. It has worked great. Not something that is done all the time though. also- IV hydration is a key..
we have had the anesthesiologist come in and give scoplamine IV but only after we had given the whole orificenal of other drugs with no relief. I have had patients just say just let me go home I am always sick and it will wear off in time. Then I just get an okay from anesthesia and let them go.
Post c/section n/v -- we give Nubain, Anzemet, or Reglan. Of the 3, I have had the most success with Reglan, then Nubain, then Anzemet. Also I've had to knock back the Toradol dose to 15mg IV instead of 30 q6h. Some people are more GI-sensitive than others.
CheesyPeach
34 Posts
do you mean 12.5 mg of DEMEROL? I have worked in PACU and SICU and have never given more than 1-2 mg of dilaudid at any given time. LOL
Demerol is the anti shiver drug. just clarifying