Pre-Op:  PEPCID IV not PO, VERSED as tolerated or appropriate, SCOPOLAMINE is usually already ordered by surgeons on their pre-op orders. Daly prefers nothing solid be given PO. **Anesthetists will need 2 single syringe pumps and be ready to dilute the haldol

Anesthesia:  After induction: HALDOL 1-4mg IV, DECADRON 0.15 mg/kg (may reconsider for DM), KETAMINE 0.5mg/kg max 50mg, ZOFRAN 4mg up front and 4mg at end for 8mg total. OFIRMEV 1000mg before incision preferably. PROPOFOL GTT, titrate to at least half mac, BIS goal 50-60's, feel free to do TIVA. The goal is to minimize Anesthetic gas particles on board-ex) Des at low flows. Separate LIDOCAINE GTT per our ERAS protocol (2% Lidocaine at 10cc/hr for 100Kg patient (adjust for IBW)). Works out to be 33mcg/kg/min Remember to turn off the propofol gtt early enough.

Post-Op:  Most patients do very well with pain control except the "bubble pain" from air under the diaphragm. This is made better by walking and time. Haldol is in the same category as Droperidol, and can be used for persistent PONV in PACU. Maybe 1mg at a time.