Table 3 Traditional opioid-including analgesic protocol for each subspecialty and perioperative phase

PreOp

Gabapentin (PO)

300 mg

Tylenol (IV)

1000 mg (may substituteto PO if IV Tylenol is notavailable)

Meloxicam (PO)

15 mg

Scopalamine Patch

Yes (if < 75 y.o.)

Single-shot spinal

1.5-2.0 cc 0.75%Bupivacaine(upright in OR)

IntraOp

Local injection

CERT

0.25% Marcaine plain5-10 mL (range basedon body habitus)

Block

Regional Ankle Block

Brachial Plexus Block

Brachial Plexus Block

Toradol

30 mg IV push x 1 dose(adjust for CrCl) (given atend of sx or in PACU)

Zofran (IV)

4 mg

4 mg

4 mg

4 mg

4 mg

4 mg

Decadron

10 mg

10 mg

10 mg

PACU

Cryotherapy

Yes

Tylenol (IV) - *up to dailymaximum dose allowableper institution

1000 mg q6h ×4 doses(continues into postop)(may substitute to PO ifIV Tylenol is not available)

PostOp

Dilaudid (IV)

0.5-1 mg q3h PRN

0.5-1 mg q3h PRN

0.5-1 mg q3h PRN

Norco

5/325 mg 1-2q4h PRN

5/325 mg 1-2q4h PRN

Tramadol

50 mg q6h PRN

Cryotherapy

optional

Yes (q8h)

optional

optional

optional

Toradol (IV)

15 mg q8h ×5 doses(can be redosed to atotal of 30 mg q8h) -available for rescue

Decadron (IV)

10 mg IV push x 1 dose

Tylenol (IV) - *up to dailymaximum dose allowableper institution

1000 mg q6h PRN*

Tylenol (PO) - *up to dailymaximum dose allowableper institution

500 mg q6hr PRN*

Gabapentin

300 mg q8hr

Meloxicam

7.5 mg q24hr

Oxycodone

5-10 mg q4h PRN

Discharge

Norco

5/325 1-2 q4h PRN(30 tab)

Norco 5/325 1-2tabq4h PRN (40 tab)

5/325 1-2tab q4h PRN(30 tab)

Percocet

5/325 mg 1-2q4h PRN(#80)

5/325 1 tab q4hPRN (30 tab)

5/325 mg 1-2q4hPRN (#80)

ASA

81 mg BID x 28d

81 mg BID x 28d

Meloxicam

15 mg q24h x 28d

Gabapentin

300 mg q8h x 14d