Management of perioperative pain

[neutropeniaboy]

Hello, again.

Do any of you residents out there know of a good article(s) or chapter(s) in a text that covers the ins and outs of perioperative pain management?

I'm stuck on the floor wondering just how much morphine is too much, or whether this patient or that should really be on a PCA, or whether Toradol is right for this guy, etc.

Thanks.

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[Neurogirl]

Talk to your seniors about it, as some attendings have very strong preferences. Also, it really depends on the patient and their underlying problems. In general though, avoid demerol (long half life metabolites), in favor of morphine. ALWAYS start low and work your way up. Also, keep an eye on pressure and respirations...as long as those are OK, you shouldn't have any major problems. Regarding PCAs, your seniors should be making those types of decisions. Interns SHOULD NOT be implimenting or managing PCAs. If they tell you to go ahead and do it, talk to anesthesia about dosing.