IT Dilaudid for Lap Colectomies

[GA8314]

Anyone doing this? 50-100 mcg IT dilaudid only, then GA for Lap colectomies....

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[HomeSkool]

Haven't done it yet, but now I'm intrigued. What results have you had so far?

 

[Arch Guillotti]

Why not give intrathecal and epidural?

 

[dhb]

Why not give intrathecal and epidural?

And they call me a troll?

 

[GA8314]

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...

 

[nimbus]

Why not give intrathecal and epidural?

And bill for both??

 

[deleted162650]

And bill for both??

Ya, but then you gotta round on 'em twice the next day.

 

[Twiggidy]

Why not give intrathecal and epidural?

 

[McPoyle]

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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[Scotty_G]

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.

 

[deleted59964]

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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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.

 

[deleted126335]

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...

The only difference is the IT dilaudid?

 

[anbuitachi]

Why only lap and not open?

 

[GA8314]

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.

 

[Noyac]

.

 

[Noyac]

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...

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.