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

From: Study protocol: randomized controlled trial of opioid-free vs. traditional perioperative analgesia in elective orthopedic surgery

   Spine (ACDF/ACDA) Foot&Ankle (HalluxValgus/Rigidus) Hip (THA) Knee (Knee Scope) Shoulder(TSA/RTSA) Hand (1st CMCarthroplasty)
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    
  1. * indicates dosing up to daily maximum allowed