PRE-OP

  • Multimodal Analgesia

      • Acetaminophen 1 g PO

      • Gabapentin 600 mg PO

      • For patients who will NOT receive Ketorolac introp: Celecoxib 400 mg PO preop

  • VTE/DVT prophylaxis

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

  • SCD usage while in bed or chair until discharge

PACU

  • SCDs from PACU arrival until discharge – while in bed or chair

NURSING UNIT

  • Diet

      • Immediately-regular diet or patient specific diet if tolerating clears

  • Ambulation

      • POD 0: 1x in hallway

      • POD 1: 3-4x in hallway

      • POD 2: 4-6x in hallway

  • HOB

      • elevated 30 degrees at all times

  • Incentive spirometry

      • 10x/hr while awake

  • IVF

      • D/C if tolerating PO intake

      • if IVF needed, balanced crystalloid (LR) preferred over 0.9% NS

  • VTE prophylaxis

      • Lovenox POD 1, if not already started

      • Continue SCD usage while in bed or chair until discharge

  • Foley

      • D/C on or before POD 1

  • Multimodal, non-opioid analgesics as first line

      • Acetaminophen 1 g PO Q8hrs (Not ordered as "while awake")

      • Gabapentin 300 mg PO QHS starting POD 0

      • Ketorolac 15 mg IV Q6hrs (not for more than 5 days)

      • Oxycodone 5-10 mg PO Q4hrs PRN

      • IV opioids for severe breakthrough pain

  • Glycemic control

      • FSBS <200

  • Consult

      • Wound nurse POD 0 if necessary