Pre-Op

• Identify patient as ERAS

• Patient Guide to ERAS Booklet

  • • Confirm they brought booklet

    • Remind importance of documenting in booklet

• Clearfast ***DOCUMENT IN DIMENSIONS***

  • • CONFIRM patient drank 3 hrs before scheduled surgery time

• PONV screening ***DOCUMENT PONV SCORE IN DIMENSIONS***

  • • Scopolamine patch (high risk only)

    • Ordered by anesthesia if needed/high risk

    • Hold for >65 years of age

    • Hold for h/o acute angle glaucoma

• Multimodal analgesia-ordered by surgeon

  • • Acetaminophen 1 g PO

    • Gabapentin 600 mg PO

      • • HOLD Gabapentin for >65 years of age: exception if already taking as home med

        • If on Gabapentin at home, patient to receive usual dose of Pregabalin or Gabapentin x1 dose

***if Multimodal not ordered, or not ordered correctly, obtain order from surgeon ( or anesthesia if surgeon not available)***

• VTE/DVT prophylaxis (ordered by surgeon)

  • • Heparin 5000 units SC (if epidural, after epidural placement)

• GI Motility (Ordered by surgeon)

  • • Alvimopan 12 mg PO (confirm patient meets dosing criteria prior to medicating patient)

    • If this medication has not been scheduled, please contact surgeon ASAP

• SCD

  • • usage while in bed or chair until discharge

• Epidural placement

  • • For open procedures or if specified by surgeon

    • Thoracic epidural placed preop at level T9

    • Standard ERAS infusion of 0.0625% bupivacaine

    • Infusion at 8-10 ml/hr

• Hand Off

  • • Confirm with CRNA ALL medications given in pre-op for safety precautions and to ensure no double dosing occurs