IT Dilaudid for Lap Colectomies
Started by GA8314
Haven't done it yet, but now I'm intrigued. What results have you had so far?
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Arch Guillotti
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Why not give intrathecal and epidural?😵
And they call me a troll? 😉
The group across town is doing it. Small dose IT dilaudid for lap (not open) colectomies. Apparently they have had great results and decreased hospital stay by over 1 day. I think they are a part of a larger study but I admit to not knowing too many details, only that our surgeons ( some of whom go to both places) have informed us of this...
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deleted87051
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deleted162650
Ya, but then you gotta round on 'em twice the next day.
I don't get this. So, where I trained nobody combined general with a neuraxial technique (obviously we used epidurals). Now, I see people in practice doing spinals with GA for things like robotic hysterectomies and bowel resections. I guess I don't understand the point?
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Where you trained they didn't care about billing or time..... PP uses a lot less epidurals in non OB pts vs an academic center. This is why some would use a single IT narcotic dose and minimize potential epidural problems on floor etc. I love doing a thoracic epidural because they can be challenging and paramedian rocks, but they are often not needed.
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deleted59964
we don't have hydromorphone so I have no experience with that, but IT morphine works well, lasts a long time, and is simple and quick to administer.
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deleted126335
Why only lap and not open?
The only difference is the IT dilaudid?
I'm not positive that's the assertion. I think it's part of their overall ERAS system, but they claim great results with this method.
We'll see. Will need to learn more perhaps.
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We have done this but the kicker is that the surgeons need to be onboard so that they will be looking to D/c the pt early otherwise the pt sits there that extra day occasionally.
