Post Partum pain management

[ragingmomster]

Hi all,

I'm looking for input for a post partum pain management project in relation to our patients in medication assisted therapy programs.

Our post-partum order sets are usually followed by our OBs.

lady partsl - Percocet 1-2 every 4 PRN and Motrin q8

C-section - Toradol in the OR, then every 8 hours x 3, Morphine PCA x 12-24 hours (1mg q10 min max 6/hr); then switch over to the same meds as PPV

Is anyone in the US using Indocin before cesareans leave the OR?

Is anyone NOT ordering Percocet or other opiates for lady partsl deliveries?

TIA,

Dawn

[iPink, BSN, RN]

Intersting to see what other facilities around the country order for SVDs vs C-secs. For mine these are the standard for each...

SVD: Ibuprofen 800mg q6 or q8 prn; Oxy IR 5-10mg q4 prn; Acetaminophen 650mg q4 or q6 prn; Percocet 1-2T q6 prn. Depending on pt's pain tolerance I would given a combo of these meds round the clock, waking them up to administer them. When I have a G10P10 mom, I really stay on top of pain meds. I also have had C-section moms who have better pain tolerance then some of my vag pts.

C/S: They usually get sent up to us with PCE (Fentanyl) and get Toradol 30mg prn if needed for breakthrough. I rarely get pt's with PCA (Dilaudid). Once off PCE/PCA within 24hours, they have the same pain meds as SVDs waiting for them to get round the clock.

Pain management is very important at my hospital because of the pts' scoring.