12 mg hyperbaric bupivacaine, 10 mcg Fentanyl, 0.1 mg morphine
Goal is NO intraoperative opioids
treated with phenylephrine or ephedrine in discretion of the anesthesiologist
ON PUMP or ephedrine 5-10 mg IV bolus
SCDs
Dexamethasone 10 mg IV
Ondansetron 4 mg IV
Goal is NO intraoperative opioids
Under body Bair Hugger
OB delays umbilical cord clamping to optimize neonatal Hgb level
Early skin to skin contact is established
Intraoperative breastfeeding is encouraged
multimodal analgesia
At end of case
Confirm with surgeon before administration
Initiated, and heavy bleeding treated aggressively with additional uterotonics
2 quadrant (Pfannenstiel incision)- 0.25% bupivacaine w/1:400,000 epi
30 mL each quadrant
To be done at end of case in Operating Room or in PACU-Depending on anesthesiologist availability
Identify as ERAS patient
Ensure to relay ALL medications given intraop to PACU RN as to safeguard against double dosing /early dosing