Implementation of an opioid-sparing protocol utilizing liposomal bupivacaine and intravenous ketorolac for pain management after living kidney donation

Table 1 Multimodal, opioid-sparing pain management protocol

Agent	Time of initiation	Dosing
Liposomal bupivacaine 13% injection (13.3 mg/mL)	Intra-operative	133 mg (10 mL) subcutaneously on each side of incision
Ketorolac	Post-operative day 0	15 mg IV Q6H for 3 doses
Hydromorphone IV PCA1	Post-operative day 0	Basal rate: None
		PCA bolus: 0.1 mg
		Lockout interval: 10 minutes
		Four house dose limit: 2.4 mg
Acetaminophen	Post-operative day 1	650 mg PO Q6H
Oxycodone	Post-operative day 1	5 mg PO Q4H as needed for moderate pain
		10 mg PO Q6H as needed for severe pain

¹Discontinued when patient able to tolerate oral medication.