Pre-Op:  We are trialing a Bariatric protocol. Aggressive anti-nausea and pre-emptive pain control. PVSLC, consider Meclizine for high risk patients

Anesthesia:  ketamine bolus, ofirmev pre-incision. Lidocaine and propofol gtt. 10mg dex on non-diabetics.

Post-Op:  consider robaxin for upper epigastric pain due to gas under diaphragm. consider haldol .5-4mg for nausea not taken care of by above measures No CPAP/BiPAP, it threatens the anastomosis