depodur

[USAnesthesiaDoc]

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Does anyone have much experience with depodur (extended release epidural duramorph)? Likes, dislikes?

 

[Planktonmd]

Does anyone have much experience with depodur (extended release epidural duramorph)? Likes, dislikes?

I never understood why we need a long acting narcotic that can only be given in the epidural space and if inadvertently injected intrathecally can cause a disaster.
If I need an epidural that works more than 24 hours then I might as well place a catheter, otherwise good old morphine should do it.
The risk clearly outweighs the benefit for this drug.

 

[amyl]

We used it at the VA without complications in my limited experience....however, policy dictated that patients given depodur spent 48h in the ICU after surgery, regardless of the patients status. the icu nurses and intesivists were often p.o.'ed as it tied up their beds. i never saw any complications or complaints (at least not from the patients ;-)) in my limited experience.

 

[2ndyear]

I have used it in C-Sections. We typically pull the epidural after the section anyways. The company data shows better and longer pain relief compared to morphine. The patients all stay for 48 hours anyways. Too bad I don't know the cost of this drug, but I'm guessing it's significantly more than preservative free morphine. No real bad side effects compared to morphine in my limited experience (about 30 cases).

I have also used it in radical retropubic prostates and had a bad case of respiratory depression that lasted way too long. Narcan drip, tied up an ICU bed. Probably not the best drug in the elderly, but for younger patients not so bad.

 

[mdjobexchange]

We use it commonly for bilateral knees and open abdominal cases. it works great. We are a VA and they have to stay in ICU for 1 day and sdu for one day. Other hospitals they can stay in sdu day one and floor day 2. Big advantage is you don't have to worry about postop anticoagulation.

 

[coprolalia]

Does anyone have much experience with depodur (extended release epidural duramorph)? Likes, dislikes?

We used it for a while, but it just isn't worth it (as others said).
Risk >> benefit.

-copro