Traditionally the agent of choice is Demerol by the intramuscular route. All of these factors combine to make pain control a confrontation between health care providers and the patient. Request for analgesics before the pre-determined time are seen as drug seeking behavior. There is expectation of pain rather than relief. The side effects of narcotics are seen as being very severe.
Addiction is though to be common.
In the pain control community Demerol is known to be distinctively inferior with a short duration of action, local irritative property, and a toxic metabolite, normeperidine, which can cause delirium and seizures in effective analgesic doses. Pain control in the wider medical and nursing community seems to be met with apathy and confrontation. Health professionals believe that their patients have good pain control so they are apathetic about need for change. Proposals for improved pain control all too often are met with confrontation. Indeed the emperor has no clothes.