Dr Matthew Checketts, NHS Tayside [PDF - 6Mb] - 18 Weeks

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ObjectivesMobilisationAnalgesia
<strong>18</strong>/10/11GPReferral• Optimise• Health Improvement• Patient Info• Start d/c planEnhanced Recovery MapPACPre‐Operative• <strong>Dr</strong>ink until2hr before• Short Fast• StartGabapentinIntra‐OperativeFast offsetGA/RA• walk on day ofsurgery• oral hydration &nourishment• Stop IV fluids inrecovery•No wound drains•No Catheters•Regular oral analgesia•minimum opioidsPost‐Operative DX on planned day Increase therapy support telephone follow upFollow‐up12
Page 1: Anaesthesia forEnhanced RecoveryArt
Page 5 and 6: • Gabapentin 300mg bdERA Package
Page 7 and 8: •THR patient 75 minutesafter end
Page 9: Pain scoresDay 0 Day 1 Day 2
Page 13 and 14: • ParacetamolMy Recipe• Gabapen
Page 15 and 16: Gabapentin & Pregabalin• anti-all
Page 17 and 18: Gabapentin, NSAIDs & Ketamine are o
Page 19 and 20: • Less pain on walking up to 32hr
Page 21 and 22: Opioid sparing effect, anti-hyperal
Page 23 and 24: Spinal Anaesthesiadose response?Bup
Page 25: Doses for ERA?• THR -• TKR -7.5
Page 28 and 29: • Clinically significant nausea &
Page 31 and 32: PCA mgmorphineused
Page 33 and 34: PNB = motor block = No Cigar!• Un
Page 35 and 36: low dose blocks?• “despite the
Page 37 and 38: Need knee brace withFNBQuickTime an
Page 39 and 40: • 1018 patients• 709 had ss FNB
Page 41 and 42: L I A
Page 43 and 44: Analgesiain thehandsof thesurgeon
Page 45 and 46: 3day reduction in LOS
Page 47 and 48: %Dundee ERA Project - 1st walk
Page 49 and 50: How do we reduce bleeding ?
Page 51 and 52: • Cochrane 2009 issue 4• >200 t
Page 53:
Transfusion risk factor for wound i
Page 56 and 57:
QuickTime and aMotion JPEG OpenDML
Page 59 and 60:
Low VTE rate1977 patientsERA patien
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Dr Matthew Checketts, NHS Tayside [PDF - 6Mb] - 18 Weeks

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