Blood Loss - Anticipate 200-900 ml of blood loss. You may be asked by the physician to keep blood pressures below a certain point (usually Systolic ~ 100 mmHg) to reduce potential blood loss. Anticipate administering TXA. Sciatic nerve - Surgeons sometimes like to monitor the sciatic nerve. They monitor this by watching for movement of the lower extremities. When the cautery gets too close to this nerve, the leg will jump. With this preference, the surgeon will be requesting no paralytic. Spinals - if you elect to perform a spinal for these cases, the addition of lidocaine (10 mg), epinephrine (15 mcg), and fentanyl (25 mcg) has been shown to be very effective at both reducing postoperative pain and discharge times. Keep drapes HIGH - its these cases that will have blood coming over the drapes.
