Table 2.

Clinical pathway protocol

Operating room anesthesia procedure
1. Single-injection ultrasound-guided interscalene block (25 cm3 0.375% ropivacaine between C5 and C6)
2. General anesthesia via LMA
Propofol/Midazolam induction
Propofol/nitrous oxide/Isoflurane maintenance
Spontaneous ventilation
3. Ketamine (50 mg)
4. IV Dexamethasone (4 mg), Ondansetron 4 mg, and Famotidine (20 mg)
5. Ketorolac, if no contraindication (15–30 mg IV; 30 mg unless age is >70 or weight is <60 kg)
Postoperative
1. Pregabalin (75–100 mg PO q 8 h × 3 days; 100 mg unless age is >70 or weight is <60 kg)
2. Meloxicam, if no contraindication (7.5–15 mg daily × 5 days; 15 mg unless age is >70 or weight is <60 kg)
3. Acetaminophen (650 mg q 6 h × 3 days)
4. Oxycodone (5–10 mg q 4 h PRN)
5. IV Hydromorphone PCA

Abbreviation: LMA laryngeal mask airway, IV Intravenous, PCA patient-controlled analgesia, PRN pro re nata (as necessary), PO per os