We recently transition from auto-verification to pharmacist verification in our periop areas. We are now having some issues with prn pain duplications. (i.e. pt was on oxycodone prn for severe pain while on the floor and then once in pacu, an order for dilaudid prn severe pain is ordered). Since these are 2 different phases of care, would having both of these ordered be allowed by TJC? If not, does anyone have any suggestions on how to navigate this scenario? Thanks in advance!

We have recently had a few of our orthopedists and anesthesiologists inquire about using low dose methadone peri-operatively at doses of 0.1-0.3mg/kg and was curious if any of your facilities had any related experiences you'd care to share. Obviously, with methadone's t1/2 of 12-60 hours, even considering using long-acting opioids for acute pain management gives me significant pause,b ut would also be concerned about QTc effects with increased methadone use. Thoughts?

We have recently had a few of our orthopedists and anesthesiologists inquire about using low dose methadone peri-operatively at doses of 0.1-0.3mg/kg and was curious if any of your facilities had any related experiences you'd care to share. Obviously, with methadone's t1/2 of 12-60 hours, even considering using long-acting opioids for acute pain management gives me significant pause,b ut would also be concerned about QTc effects with increased methadone use. Thoughts?