Anaesthetists Handbook - MEDICAL EDUCATION at University ...

Epidural anaesthesia and analgesiaGuidelines for discharge from PACU to the ward for colorectalpatients with epidural or intrathecal analgesiaPatients may be transferred to the enhanced care unit on ward 22with epidural or intrathecal analgesia after a period in recovery aslong as the following criteria are met.• A minimum of two hours in recovery• Review by anaesthetist or pain team whilst in recovery to ensureefficacy of analgesia, and respiratory and cardiovascular stabilityincluding signs of early surgical complications such as bleeding.• Completion of medical notes to verify suitability for transfer• The ward staff reserve the right to decline to take the patientback to the ward if they are not content with any aspect of thepatient’s condition.• If there are any causes for concern the responsible consultantsurgeon and anaesthetist (or their deputy) should be contactedto review the patient in recovery.• The Pain Team will continue to follow-up the patients on theward.If the patient does not meet the above criteria and requires level 2 or3 critical care, the discussion must take place with the consultantintensivist on call as early as possible so that alternativearrangements can be made.Prescriptions for ward based epidurals[Dr A. Thacker, September 2009]All patients with epidurals to be admitted to PACU or another areaoutside critical care must have the following correctly prescribed onthe ‘as needed’ section of the drug chart:1. Epidural infusion.Anaesthetists Handbook January 2010 141