Spinal Fusion Pathways

Information Given to Family at Pre-Admission Testing Appointment

• Discuss plan and associated risks including:
• Endotracheal tube (ETT),
• Total intravenous anesthesia (TIVA),
• IVs, invasive monitoring, possible need for central access,
• Pain management, IT morphine injection,
• Risk of vision loss,
• Potential need for blood transfusion,
• Post-op facial swelling andpressure points.
• Time of arrival for surgery and where to check in.
• NPO instructions.
• Instruct patient to drink 10-12 oz of clear carbohydrate drink 2 hours prior to arrival.
• Bathing protocol- Per Physician Preference.
• Verify Procrit (epoetin alfa) regimen if ordered by the surgical service.

Pre-operative Labs

• Type & Screen, CBC, chem-8, coagulation studies (INR, PT, PTT).
• Pregnancy Test.
• COVID-19 Test.

Order Appropriate Medications

• Premeds for anxiety as indicated.
• Gabapentin for day of surgery:
• 600 mg for patients weighing > 50 kg, or
• 10 mg/kg for patients < 50 kg.
• Anti-emetic: if high-risk, consider Emend and placing a Scopolamine patch (1mg) behind the ear in preop area. It should remain on the patient for 72 hours.