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 β 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