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Periacetabular Osteotomy (PAO) — Anesthesia Team Preoperative Preparation for PAO — Clinical Pathway: Inpatient

Periacetabular Osteotomy (PAO) Clinical Pathway — Inpatient

Anesthesia Team Preoperative Preparation for PAO

Room Preparation

Utilize Level II Forms in Preoperative Navigator
  • 2 age-appropriate LR IV bags available
  • 2-D ultrasound, Sonosite, for nerve block
  • 2 infusion pumps
  • Hotline
  • Sedline monitor if planning a TIVA
  • Bair Hugger (upper body)
  • Ensure 1-unit PRBCs autologous or donor available before start of case
  • Cell saver arranged by surgery

IV Bolus Medications

Utilize Anesthesia PHL General Requisitions
Order Set
  • Acetaminophen
    • 10-15 mg/kg/dose depending on age and weight (max 1,000 mg)
  • Methadone
    • Dispensed as a 10 mg/ml syringe
    • 0.1 mg/kg up to 10 mg
  • Tranexamic Acid
    • 30 mg/kg over 10 min, max 2,000 mg

IV Infusions

Hypnotic/Analgesic Agents if planning a TIVA
  • Propofol
    • 100-250 mcg/kg/min
    • See Propofol Dosing
    • Propofol dosing guide Epic screenshot
      © 2024 Epic Systems Corporation
  • Remifentanil
    • 0.1-0.2 mcg/kg/min
    • Determine concentration using the Remifentanil Infusion Ordering Guide
    • Remifentanil concentration dosing guide Epic screenshot
      © 2024 Epic Systems Corporation
Other
  • Tranexamic Acid 100 mg/ml
    • 10 mg/kg/hr

 

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