dVH/RALH: Morphine or Dilaudid Post-Op?

I have had a morphine PCA pump in the past after extensive foot surgery, and I did just fine with it -- I just felt high the whole time, but it helped the pain.

On my first ER visit with the abdominal pain that is resulting in my supracervical hysterectomy, the nurse gave me anti-nausea drugs (Zofran, I think) and morphine. This was AFTER I had the CT scan and drank the horrible contrast stuff.

Almost immediately after giving the morphine in my IV, I threw up. The 2nd ER visit 3 months later, the doctor gave me Dilaudid instead.

I told the NP all of this during my pre-op visit, and she said they would give me a morphine PCA pump and also make sure they gave me Zofran at the same time.

I feel kind of nervous about this, though, because I don't want to throw up.

Any ideas or suggestions?

My surgery is 1 week from today, and it can't come soon enough. I had really bad, stabbing pain last night for several hours, and I am so tired of it -- I hope that was the last "pain episode" for me...

Thanks,

Dana B. in Houston, TX

I had cervical spine surgery 3 years ago, and had Dilaudid with no problems. It didn't make me sick or anything. I did have nausea meds and a scopalamine patch w/ my anesthesia, though. But I had good luck in the hospital with it with no ill effects. I hope you get what you want and best of luck to you. Mine's four days after yours.
Kelly

I had a TAH/BSO in March.
Diluadid was EVIL for me. I was fine after surgery. I had an epidural for surgery and had little to no incision pain. As that wore off they gave me diluadid I went downhill fast. It turns out I had a spinal migraine (from the epidural) the diluadid didn't help anything it just made me VERY nauseated. They tried 2 or 3 different nausea meds. I was sick for 3 days. It postponed my castle release by 2 days.

Stick with what worked for you the last time you had surgery.
My recovery was no problem with Motrin & Tylenol.
May the good medication goddess be with you!

I went with dilaudid, thIs surgery and my last surgery. I'm one of those rare people that morphine causes psychosis, paranoid delusions. I still feel pain while on it.
I had a Dilaudid PCA pump + ONQ continuous pump. OnQ is a pain pump which administers local anesthesia directly to the would site. Having had previous abdominal surgeries I can say without a doubt I had far less pain in the first week of post-op than in previous surgeries. Google it OnQ. Then ask your doc for it.

Hi. Anesthesia pre-op said they would give Zofran for anti-nausea b/c it didn't have the same blood pressure lowering effects as phenergan which I take fairly regularly b/c of Celiac disease. I haven't had problems w/morphine, but am scared to wake up and be pukey feeling b/c of the anesthesia and throwing up complicated w/the Celiac. Anesthesia said they would give me Phenergan if the Zofran wasn't effective. I LOVE Phenergan for anti-nausea!

I have had both morphine IV & pump and dilaudid oral and injected. I find the morphine is not as effective and gives me a headache. As a chronic pain patient I can share information I have learned regarding narcotic pain medication. If you ask for a specific drug - you will not get it.
Ridiculous? yes. True? yes. Why? You can thank the government and all the abusers in the world. The medical community is now so focused on deterring drug seeking behavior, it is at the detriment of patients in pain. I suggest you discuss this with your doctor and express your concern. Ask them if there are options and let them know you had a better experience with Dilaudid. It might help you get the dilaudid or it might not. You might end up with something less effective. Look into toradol, it is a longer acting anti-inflammatory medication that is very effective in pain relief. If you are still unsatisfied with your pain relief plan of care you can contact the hospital and ask to speak with the pain management team. They may be better able to help you. Some doctors are much better at addressing the pain management needs of their patients than others. I have had surgeons on both ends of the spectrum. Boy does it make a difference.
Keep in mind your surgeon does not want you to vomit post op. It is possible the morphine was not responsible for your vomiting. Good luck

i honestly don't know what was in my surgical i.v. for pain or anti-nausea -- when the nurses woke me up from general anesthesia, i had terrible pain, but they gave me something and it worked right away. about 5-6 hours later, i was nauseated as soon as i got out of bed to use the toilet the first time. dry heaves first time, vomiting second trip to toilet...yay. i was on dilaudid at that point, and it was the nurses who suggested that might be messing with me. i got switched to toradol. was already getting zofran anti-nausea in post-op i.v. at that point, and that combo did the trick. switched to phenergan the next day, as soon as i could swallow pills -- (i woke with a dry-as-cotton mouth, which lasted until they finally upped my i.v. fluids around 24 hours post-op.) went home with percocet and motrin 600 mg. i was fine without a pca-pain pump -- but nurses helped me stay on top of getting pain meds in i.v. at right intervals. the nurses were really helpful, for the most part. did not even see my doc once until 3 pm the following day!

whatever happens for you, just clearly communicate what is going right or wrong, and hope for the best. don't be anxious about the unknown. throwing-up was one of my worst post-op fears, and even so, it all worked out -- i was pretty sure nothing i could do would shock the nurses, and they helped me with nearly everything. the first hours are so hard, but it passes so quickly. i hope you will be fine!!