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

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Enhanced Recovery• Empowers the patient to lead their rehab• Facilitates early mobility• Provides effective analgesia• Reduced side effects• Reduces Hospital LoS• reduced HAI? Patients happy, £250per day saved• Reduces Mortality
• Gabapentin 300mg bdERA Package• Tranexamic Acid 15mg/kg• Spinal anaesthesia 10mg LB, no opioid• Local Anaesthetic Infiltration (LIA)• 150 ml 0.2% Ropivacaine• LA infusion for 24 hrs (for TKR only)• 10 ml/hr 0.2% Ropi via elastomeric ball• No routine catheter or postop iv fluids• Oxycontin/Paracetamol/NSAIDs8
Page 1 and 2: Anaesthesia forEnhanced RecoveryArt
Page 3: 18/10/11GPReferral• Optimise• H
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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