From: Jerry Robinson Pharm.D.
To: Pharmacists
Sent: Friday, January 19, 2018 2:47:56 PM
Subject: Pre and Post OP multimodal pain management - now in Colon/Rectal patients

Similar to Joint Camp, patients undergoing surgery involving the colon or rectal areas are now receiving multimodal pain management as the standard of care.

For PreOp review - please handle similar to Joint Camp. Look for gabapentin or Lyrica use prior to hospitalization.

PreOp order set can be found on Pulse or click here.

For PostOp:
- should see a decrease in PCAs ordered [no longer a check box]
- multimodal pain management has a box to DISCONTINUE if the surgeon prefers a different regimen
- watch for other pain medications ordered separately
- the oxyCODONE and/or Dilaudid should only be on the patients profile in iCare IF that patient has seizures (avoid Ultram) or allergy to morphine (use Dilaudid)
- watch for gabapentin or Lyrica as home medication with Gabapentin ordered from order set. If appropriate, home regimen is preferred over the multimodal gabapentin regimen.

Post Op order set can be found on Pulse or click here.

If you have questions or comments, please send them to Jerry Robinson. Thanks.

Jerry Robinson, Pharm.D., BCPS
Clinical Specialist STICU/Co-Chairperson, Medication Safety Committee Department of Pharmacy Huntsville Hospital