Right after we wheel a mother from the OR - c/s with BTL - into recovery, the anesthesiologist deemed it necessary to immediately take out her epidural catheter "because of some sterility breakdown". 15 minutes later the mother was in agony. My preceptor mumbled something about the "stupid doctors", but it was left to me to let the MDs know that her pain scale was 8. Why nobody anticipated this I don't know. I mean, hell, you just cut open a woman, you should expect her to be suffering if you inadvertently had to remove her only source of relief. Finally, they ordered morphine PCA. Meanwhile, no one knew where to get a pump, or even how to work one. Another 15 minutes go by and the mother is now burning up with pain, and I am frantic. I asked if something could be done while we are getting the PCA set up, and finally, one MD tells me I can give her 10 mg morphine SC stat.
My question is, in your experiences, was this 10 mg SC the right thing for this woman? Bear in mind she has DM and is totally insulin dependent, morbidly obese, and has asthma and cholestasis. I am so torn because I really don't know what the right pain medication for her should have been. I know this was ordered only because I insisted on something being done, but being a stupid newbie, I didn't really know what exactly she should be getting. And because I found the doctors so apathetic, I don't know for sure if they did the right thing.
Is there anything else one could do for a post c/s pain when the epidural fails?
