Spine Fusion ERAS Protocol

Last updated: February 9, 2026

Induction
Methadone 0.1-0.2 mg/kg; Dexamethasone 0.1 mg/kg (max 10 mg), tranexamic acid bolus (30 mg/kg max 2gm) over 10 minutes, Induction (propofol/fentanyl/lidocaine)
Maintenance
Propofol gtt. Remifentanil (0.1-0.2 mcg/kg/min). tranexamic acid gtt 10 mg/kg/hr. Nicardipine and Phenylephrine in line for tight BP control
Emergence
Ondansetron 0.1 mg/kg, IV acetaminophen, additional opiate PRN
pre-op
Acetaminophen PO
Standard MAP Guidelines
. 60-70 for Dissection/screw placement, 70-80 Rod placement/distraction, 65-75 for closure