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***

  • • Ordered by anesthesia if needed/high risk

    • Scopolamine patch (high risk only)

      • • Hold for >65 years of age

        • Hold for h/o acute angle glaucoma

• Multimodal analgesia-ordered by surgeon

  • • Per the Multimodal Medication Dosing Tool

    • Celecoxib 400 mg PO (reduce dose to 200 mg if >65 years or < 50 kg. Do not order if GFR <60 mL/min, Stage 3 CKD)

    • Acetaminophen 1 g PO

***If any of the above medications are not ordered, or not ordered correctly, contact surgeon ASAP for correction (contact anesthesia if surgeon not available)***

• Maintain normothermia

• Blocks/Cath/Spinal

• TKA

  • • Selective Femoral (Adductor Canal) Nerve catheters0: Initial block max 20 mL of 0.25% bupivacaine then infusion of 0.2% Ropivacaine, 8-10 mL/hr

• TKA/THA Spinal

  • • Choose local anesthetic that allows for most rapid resolution of spinal as postop goal is early ambulation

• Shoulder

  • • Interscalene catheter and superficial cervical plexus block 0.25% bupivacaine w/epi

• Hand Off

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