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/clinical/cckm-tools/content/order-sets/inpatient/pain-management/name-98073-en.cckm

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Anesthesiology - Lidocaine for Postoperative Pain - Adult - Supplemental [4100]

Anesthesiology - Lidocaine for Postoperative Pain - Adult - Supplemental [4100] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Pain Management


SmartSet: ANESTHESIOLOGY - LIDOCAINE FOR POSTOPERATIVE PAIN -
ADULT - SUPPLEMENTAL (ID:4100)
General Information
Display name: Anesthesiology - Lidocaine for Postoperative Pain - Adult - Supplemental
Type: General
Merge priority: 0
Version comment:
Content source:
Synonyms: 1. .PAIN
SmartSet notes:
Description:
Web information: Title URL
1. Intravenous Lidocaine for
Postoperative Pain
https://uconnect.wisc.edu/clinical/references/pain-
management/references-
guidelines/resources/name-34149-en.file
Questionnaire:
Configuration
PACU
Patient Monitoring
Assess for Lidocaine Side Effects Every 30
Minutes
SEE COMMENTS, Starting S For Until specified,
PACU
If Patient Develops Mild or Moderate Side
Effects
SEE COMMENTS, 1. Stop lidocaine infusion
2. Obtain and document side effects, blood pressure
and pain rating
3. Notify Anesthesiologist and obtain an order for a
serum lidocaine level, PACU
Contingency Parameters
Page 1 of 3
Printed by STRAKA, KEVIN F [KFS1] at 8/1/2016 1:25:08 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 08/2016CCKM@uwhealth.org

Notify Anesthesiologist Provider to Notify: Other (Comment)
If systolic blood pressure > (mmHg):
If systolic blood pressure < (mmHg):
If diastolic blood pressure > (mmHg):
If diastolic blood pressure < (mmHg):
If temperature > (C):
If temperature < (C):
If heart rate > (bpm):
If heart rate < (bpm):
If respiratory rate >:
If respiratory rate <:
If blood glucose > (mg/dL):
If blood glucose < (mg/dL):
If pain score >:
Pulse Oximetry < (%):
If urine output < (mL):
Other: If patient develops mild or moderate side
effects due to lidocaine infusion or if lidocaine is
stopped because of side effects
PACU
PostOp/Phase II
Vital Signs
Vital Signs (Blood Pressure, Pulse Rate,
Respiratory Rate)
SEE COMMENTS, Routine
Temperature Measurement Method:
Temperature Measurement Restrictions:
BP Source:
BP Location:
BP Position:
BP Restrictions:
Monitor PRN if side effects develop during lidocaine
infusion (temperature not needed), Post-Op/Phase II
Patient Monitoring
Assess for Lidocaine Side Effects With Every
Set of Vitals
CONTINUOUS, Starting S, Post-Op/Phase II
If Patient Develops Mild or Moderate Side
Effects
SEE COMMENTS, 1. Stop lidocaine infusion
2. Obtain and document side effects, blood pressure
and pain rating
3. Notify primary team and obtain an order for a
serum lidocaine level, Post-Op/Phase II
Contingency Parameters
Page 2 of 3
Printed by STRAKA, KEVIN F [KFS1] at 8/1/2016 1:25:08 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
08/2016CCKM@uwhealth.org

Notify Provider Provider to Notify: Provider
If systolic blood pressure > (mmHg):
If systolic blood pressure < (mmHg):
If diastolic blood pressure > (mmHg):
If diastolic blood pressure < (mmHg):
If temperature > (C):
If temperature < (C):
If heart rate > (bpm):
If heart rate < (bpm):
If respiratory rate >:
If respiratory rate <:
If blood glucose > (mg/dL):
If blood glucose < (mg/dL):
If pain score >:
Pulse Oximetry < (%):
If urine output < (mL):
Other: If patient develops mild or moderate side
effects due to lidocaine infusion or if lidocaine is
stopped because of side effects
Lidocaine
lidocaine 2000 mg in dextrose 5% 500 mL
infusion
1.33 mg/kg/hr, Intravenous, CONTINUOUS For 48
Hours
Begin/continue in PACU. Administer lidocaine as
secondary infusion. Discontinue lidocaine when bag
is empty
Post-Op/Phase II
Criteria
Suggestions:
Filter: UWIP ORDER SET RESTRICTION - HOSPITAL ENCOUNTERS EXCEPT ED -
NOT IP DC[3000400]
Restrict SmartSet:
Settings
Discontinue action:
Deselect sections for
Pended/Held orders:
Pended/Held orders
display:
Release date: Use System Definitions Setting
Disallow user override:
Page 3 of 3
Printed by STRAKA, KEVIN F [KFS1] at 8/1/2016 1:25:08 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised:
 
08/2016CCKM@uwhealth.org