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Robert McKenna, MD 


(310) 486-6765

Thoracic Epidurals

It is of the utmost importance that you contact Dr. McKenna (310) 486-6765 prior to removing thoracic epidural catheters.  The same goes for Dr. Onugha (310) 902-4113.


Please DO NOT trust that the RN knows what the thoracic surgeon wants to do with the epidural.  Have physician to physician communication.


Also, place a "Nursing Communication" Order:

  • When logged into patient's chart, go to the Orders tab, then click on "Orders" and scroll to the bottom

  • On the "Additional Order and Order Sets Search" box, enter "nursing communication" and click on that order

  • Type in the nursing communication order, something to the effect of: "Please instruct any anesthesiologist/pain management doctor to contact the surgeon before removal/discontinuation of thoracic epidural catheter.  There MUST be physician-to-physician communication prior to epidural catheter removal."

  • Make the order last 10 days, which is typically the maximum amount of time an epidural catheter should be left in place.






Double Lumen Tubes

Always the opposite side of whichever side he is operating on

Lines, Blood Availability, Issues

Always discuss with thoracic surgeon before transfusing blood product

Place a pre-induction a-line in cases with large mediastinal masses or any other conditions which could impair cardiac filling on induction.


McKenna uses Exparel in his intercostal nerve blocks

Foley Catheter/Bladder Scan

Unless patient requests urinary catheter or it is agreed upon pre-operatively with the surgeon (please discuss with surgeon), NO FOLEY catheter at start of anesthesia.  Bladder scan will be performed and if scan shows bladder volume of 300mL or greater, straight cath or indwelling foley (anesthesiologist's decision) to be placed.

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