mine, decadron or 2mg of magnesium sulfate.
Post-op: Repeat the APAP IV 6 hours after the procedure. Provide the
patient with oral APAP for two days. If necessary, administer an ultra-
sound guided adductor canal block or IPACK block with 0.5% ropiva-
caine plus decadron for break through pain. Or you can schedule a
ketorolac IV every 8 hours twice daily.
Dr. O'Con explains:
Pre-op: Administer an
interscalene nerve
block with ropiva-
caine + epi at each
block site. The nerve
blocks are adequate
to keep the patient
pain-free for 12 hours
after surgery.
Intra-op: The anesthetist may administer minimal amounts of keta-
mine and propofol if necessary and if surgery is done with blocks as
the sole anesthetic.
Post-op: Handled by surgeon.
Mr. Schneider explains:
Pre-op: Give the patient Tylenol, clonidine and gabapentin and
administer an ultrasound guided interscalene brachial plexus nerve
block with catheter using 10-15 cc of 0.5% ropivacaine with 4mg
decadron. I use ropivacaine because it is less cardiotoxic unless there
9 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M a r c h 2 0 1 7
Katrina O'Con, DNAP, CRNA
Pre-op:
• 20 cc of 0.5% ropivacaine +
epinephrine
Intra-op:
• Ketamine (optional)
• Propofol (optional)
Shoulder
