Gynaecological surgery patients - standing order for premedication

This standing order is for the administration of Oxycodone MR and either Ibuprofen or Etoricoxib as analgesic premedication. They may be omitted on the request of the anaesthetist.

It applies to all ASA 1 or 2 patients (>50kg) having:-
     
               laparoscopic procedures
               endometrial ablation procedures

Please check with anaesthetist before pre-medication for Cameron Martin lists

Ibuprofen should be considered for use in patients under 65 years unless any of the following apply:-

• peptic ulcer disease * see Etoricoxib guidelines (esp. contraindications)
• renal impairment
• bleeding disorder
• known adverse reaction to aspirin or other NSAID

In the case of asthma, administration should first be discussed with the Anaesthetist managing the list. Asthma alone is not a contra-indication.

Patients already taking NSAID’s should also first be discussed with the Anaesthetist

Prescription:    Oxycodone MR 10mg       orally

and                   Ibuprofen 800mg             orally

or                      Etoricoxib 90mg               orally

• to be administered by the nurse after the patient has been clerked
• the nurse records the drug/dose/time of administration on the front page of the drug Kardex
• the admitting doctor is responsible for signing the prescription