Busy Day On Acute Pain
What a crazy day – the first epidural I’ve ever had to abandon, a myriad of acute pain consults, continuous block of the brachial plexus at the axilla, rectus sheath block x 6, post-op TAP block… and more Tegaderms than I want to remember right now. The culture here is all about enhanced recovery after surgery (ERAS) – minimizing parenteral narcotics, encouraging early ambulation, aggressive pulmonary toilet, and the like. As a result, I’m becoming accustomed to transitioning patients off of epidural infusions (usually bupivacaine and Dilaudid/fentanyl) over to IV PCAs (Dilaudid or fentanyl) and ultimately to oral medications (tramadol, Norco, Celebrex, Lyrica, etc.)
In other news, MD Anderson recently opened up a new portion of the hospital (the “Pavilion”) with more operating rooms and a post-anesthesia care unit (PACU) extension. Here are some pictures of the (almost complete) PACU.