Embedded Files
Younger Patient/Opioid Naive
Younger Patient/Opioid Naive
Preop
Gabapentin 600 mg
Acetaminophen 1000 mg
Intraop
Magnesium 2 g bolus + 10 mg/kg/h infusion
Ibuprofen 600mg IV Bolus
Ketamine 20 mg IV Bolus
PACU (PRN)
Hydromorphone 0.2 mg IV q15min for pain 3-5
Hydromorphone 0.4 mg IV q15min for pain 6-8
Fentanyl 50 mcg IV q10min for pain 9-10
Younger Patient/Pre-op Opioids
Younger Patient/Pre-op Opioids
Preop
Gabapentin 600 mg
Acetaminophen 1000 mg
Oxycontin 10 mg (or patient's usual AM dose)
Intraop
Magnesium 2 g bolus + 10 mg/kg/h
Ibuprofen 800 mg IV
Ketamine 20 mg IV Bolus + 10 mg/h infusion
PACU (PRN)
Hydromorphone 0.4 mg IV q15min for pain 3-5
Hydromorphone 0.8 mg IV q15min for pain 6-8
Fentanyl 100 mcg IV q10min for pain 9-10
Senior Patient/Opioid Naive
Senior Patient/Opioid Naive
Preop
Gabapentin 300 mg
Acetaminophen 1000 mg
Intraop
Magnesium 2 g bolus
Ibuprofen 600mg IV Bolus
PACU (PRN)
Hydromorphone 0.1 mg IV q15min for pain 3-5
Hydromorphone 0.2 mg IV q15min for pain 6-8
Fentanyl 25 mcg IV q10min for pain 9-10
Senior Patient/Pre-op Opioids
Senior Patient/Pre-op Opioids
Preop
Gabapentin 300 mg
Acetaminophen 1000 mg
Oxycontin 5 mg (or patient's usual AM dose)
Intraop
Magnesium 2 g bolus + 10 mg/kg/h
Ibuprofen 600mg IV
PACU (PRN)
Hydromorphone 0.3 mg IV q15min for pain 3-5
Hydromorphone 0.6 mg IV q15min for pain 6-8
Fentanyl 75 mcg IV q10min for pain 9-10
APFEL Scoring for PONV
APFEL Scoring for PONV
(1 point for each)
Female gender
No smoking status
Anticipated use of opioids after Sx
h/o PONV or motion sickness
0-2 = Dexamethasone + Ondansetron
3 = + Scopolamine
4 = + propofol infusion or TIVA
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