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View Full Version : Sedation (IV) after surgery



Tilda
07-20-2008, 10:09 AM
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C.M. Daniels
07-20-2008, 10:52 PM
After my most recent surgery, I was given morphine while in recovery. That kept me sedated like nobody's business. As far as dosage, I'm not sure. It will vary from person to person, what dose they get.

I wish I could be of more help.

Izunya
07-21-2008, 02:41 AM
Demerol! Lovely, lovely demerol, so . . . bendy . . .

Seriously, I'm not a medical professional, so I don't know much about this stuff. I do know that after gall-bladder surgery, I was given Demerol. I also know that all my female relatives go pretty loopy on Demerol. I'm a fairly mild case; I just acquired a cheerfully unrestrained potty-mouth. My grandmother patted the doctor down to find her purse.

In other words, Demerol is a very strong painkiller. It doesn't knock a person out, but you can't exactly do algebra when you're on it, either. I think how much they sock you with depends on your body weight, but they can hook you up with a self-administer button—on a timer, of course, to prevent overdose. You can actually feel the stuff moving through your body.

It's also, IIRC, pretty strictly controlled because it can be seriously addictive.

Izunya

Chumplet
07-21-2008, 02:51 AM
My sister had a little button on the end of a wire that administered Demrol when her pain was making her toes curl. It allowed a bit of painkiller to flow from her IV as needed.

Horseshoes
07-21-2008, 06:40 AM
First need to know the pt and surg. Any medical hx and complications, age, gender, oregnant, health hx and type surg. Verr diff for a lung cancer pt who just lost two lobes of a lung v. a 20 yo who just had a compound arm fx repaired.

Also, although tv uses sedation loosely, medical folk usu do not. Sedation and pain control meds are verr often not the same.

Tsu Dho Nimh
07-21-2008, 02:44 PM
Sedation is to calm them down - valium and tranquilizers

Pain relief is to stop it from hurting: morphine, demerol, and those

GeorgeK
07-24-2008, 04:58 AM
Sedatives like the benzodiazepines are usually avoided post op unless the person is chronically on them, or an alcoholic. There are some doctors that like to prescribe them, but surgeons usually prefer the patients to be awake enough to assess mental status changes which could be an early sign of sepsis. Also the patients are likely to be taking other drugs which will interact with the benzo's. If the patient is in a monitored bed (ICU, CCU Surgical Telemetry) they are more likely to be willing to prescribes those since if they stop breathing a monitor will go off. Opioids like morphine and demerol are common and sometimes NSAID's (non-steroidal anti-inflammatory medications, like ibuprophen, ketorolac, ketoprophen etc) depending upon the circumstances. That said, too much of the opioids can do the same things as the benzo's. Everyone's tolerances are a little different


Hello!
following a gunshot, ...he's restless and still in pain. What sort of sedation would the doctor/nurse administer and how much (i.e "...XX ml/mg/something else of XX")? I read about something called Midazolam. Would this do, and if so, how much if the doctor wanted the patient to rest for another three hours or so?
Thanks bunches! :Sun:
Getting shot is supposed to hurt. Pain is there to tell you to do/not do something. Taking so much pain meds post op that there is no pain usually means they will stop breathing or do something stupid and burst open the surgical wound. Pain is exhausting. If they have adequate pain control they won't need midazolam to rest. It is also fairly common that the first night after surgery is the best as far as pain control because there will still be a little of the gerneral anaesthetic hanging around and the person isn't being made to walk the halls. The worst days are post op days 3-5.

I usually started patients on a demerol pca (patient controlled anasthesia) they press a button and get a shot, but there are lockouts so they can't go over a certain dose in a given time. Pressing the button more often, just makes a beep, not extra drugs. A typical starting parameteter for an average sized healthy man (other than the gsw) might be 10 mg dose up to every ten minutes if the patient presses the button at every oppurtunity. If people get spacey, you reduce the dose or increase the lockout time depending upon how they are doing. If they hurt a lot and can't sleep and can't get out of bed because of pain, then increase the dose or reduce the lockout time. A typical starting lockout for morphine would be 1 mg up to every ten minutes.

They might also get ketorolac (toradol) sort of a cousin of ibuprophen available IV, also maybe acetominophen suppositories (Trauma patient's post op are going to be npo (nihil per orem) or (nothing by mouth) so they won't be taking much in the way of pills. It will be IV, shots or suppositories).

I liked diphenhydramine 50mg if they wanted something to help them sleep. Other surgeons used some of the benzo's, but I saw a lot of drug interactions with them (particularly the elderly and chronically ill...google sundowning) and so tried to avoid them.