PRE-OP
PRE-OP
- Multimodal analgesia
Gabapentin 600 mg PO x1
Celecoxib 400 mg PO
- VTE/DVT prophylaxis
Heparin 5000 units SC (if epidural, 2 hrs after epidural placement)
- SCD
While in bed or chair until discharge
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PACU
PACU
- SCDs
From PACU arrival until discharge β while in bed or chair
ICU
ICU
- Pulse oximetry
Continuous x24 hrs
- Entereg 12 mg PO Q12
Starting POD 0
- Multimodal, non-opioid analgesics as first line:
Ofirmev 1 g IV (15mg/kg) Q8 OR Acetaminophen 1 g PO Q8 (Depending if patient able to take PO)(Not ordered as "while awake")
**NO for right lobe resections**
Gabapentin 300 mg PO QHS starting POD 0
Celebrex 200 mg PO Q12
Oxycodone 5-10 mg PO Q4 PRN
IV opioids for severe breakthrough pain
- IVF
Balanced crystalloid (LR)
- VTE
- GDFT
**Continue: SV optimization protocol
- Incentive spirometry
10x/hr while awake
- Diet
POD 0: Clears
POD 1: Advance to GI soft diet
- Foley
Removal POD 1 evening
Male patients-foley remains in place until 6 hrs after epidural discontinuation
- Ambulation
POD 0: Out of bed to chair
POD 1: Ambulate 2-3x in hallway
- Glycemic control
FSBS <200
- Consults
Nutrition Consult β to follow through discharge
Wound nurse POD 0 if necessary
NURSING UNIT
NURSING UNIT
- Ambulation
POD 2: 3-4x in hallway, OOB 6 hrs in chair or ambulating
POD 3 until D/C: 4-6x in hallway, OOB 8 hrs in chair or ambulating
- Diet
Regular diet or patient specific diet
- HOB
Elevated 30 degrees at all times
- Incentive spirometry
10x/hr while awake
- VTE prophylaxis
SCD usage while in bed or chair until discharge
Heparin/LMWH
- Glycemic control
FSBS <200
- Entereg 12 mg PO Q12 hrs
- D/C per criteria
- Multimodal, non-opioid analgesics as first line
Acetaminophen 1 g PO Q8 (Not ordered as "while awake")
Gabapentin 300 mg PO QHS starting POD 0
Celebrex 200 mg PO Q12
Epidural 0.0625% Bupivacaine (NON-NARCOTIC)
Epidural D/C POD 2 or 3
Oxycodone 5-10 mg PO Q4 PRN
IV opioids for severe breakthrough pain
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