- First, give adequate fluid resuscitation b/c hypovolemia from vascular leak and hemoconcentration can cause ischemic pain and resultant lactic acidosis. Fluid replacement is the first step to treating pain in these patients.
- IV opioids, usually PCA pump. Hydromorphone or fentanyl (intravenous),
- Morphine is fine. Even though morphine can cause an increase in sphincter of Oddi pressure, it’s not clinically significant. No need to prefer meperidine over morphine.
