Table 1.
Perioperative Pain management protocol.
| Timing of Intervention | Dose | Route | Frequency | Details |
| Preoperative | ||||
| Gabapentin | 300 mg | Oral | 3 doses | Given at night, starting on night before surgery |
| Intraoperative | ||||
| Subarachnoid block 0.5%Bupivacaine Heavy + Buprenorphine |
15–20 mg 1 μg/kg |
Intrathecal Intrathecal |
||
| Antibiotic Cefuroxime |
1.5g | Iv | Prior to surgery, 2 doses thereafter, 12 hourly | |
| Adductor canal block Ropivacaine |
15 ml of 0.2% | Adductor canal | 1 dose | Ultrasound guided, prior to surgery |
| Midazolam | 0.02 mg/kg | Iv | 1-2 doses | |
| Pantoprazole | 40 mg | iv/oral postop | 1 dose | Continued I dose daily before breakfast |
| Paracetamol | 1g | Iv | 1 dose | |
| Tranexamic acid | 500–1000 mg(10 mg/kg) | Iv | 1dose | |
| Methylprednisolone | 500 mg | Iv | 1 dose | |
| Ondansetron | 4–8 mg | Iv | 1 dose | |
| Local infiltration | Unilateral | Intra articular | The mixture is diluted to 100 ml and infiltration is done with 20 ml syringes and 18g needles | |
| Levobupivacaine 0.5% | 30 ml | |||
| Clonidine | 75 μg | |||
| Fentanyl | 100 μg | |||
| Adrenaline 1:1000 | 2drops | |||
| Ketorolac | 30 mg | |||
| Tranexamic acid | 1g | |||
| Postoperative on day of surgery | Drain kept clamped for 4 h, then released | |||
| Paracetamol | 1g | Iv | 2-3doses | |
| Ice application | Locally | 4 times a day | For 2 days | |
| Postoperative day 1 | ||||
| Paracetamol | 1g | Oral | 2-3 times | |
| Tramadol | 50 mg | IV | Rescue analgesic | |
| Dalteparin sodium | 5000U | Sc | Once daily | Till discharge |
| Buprenorphine patch | 10 μg/h | Transdermal | once | |
| Nandrolone decanoate | 100 mg | Im | 1 dose | |
| Vitamin C | 2g | Oral | 5 doses | One dose a day |
| Multivitamin with Zinc | Oral | 5 doses | One dose a day | |