Enhanced recovery after surgery protocols
Enhanced Recovery After Surgery (ERAS) is a multimodal, evidence-based approach to perioperative care that aims to optimize the entire surgical experience, from preoperative assessment to postoperative recovery. The goal of ERAS is to reduce stress on the body, minimize complications, and accelerate recovery, ultimately improving patient outcomes and satisfaction. ERAS protocols are designed to enhance the recovery process and decrease the length of hospital stays.
Key components of Enhanced Recovery After Surgery typically include:
Preoperative Education: Patients receive detailed information about the surgical process, expectations for recovery, and strategies for active participation in their care.
Preoperative Nutrition: Emphasis on optimizing nutritional status before surgery to enhance healing and reduce the risk of complications.
Preoperative Fasting: Minimizing the duration of preoperative fasting to reduce the risk of dehydration and insulin resistance.
Multimodal Analgesia: Using a combination of pain management techniques, including regional anesthesia, non-opioid medications, and local anesthetics, to control pain effectively and minimize opioid use.
Early Ambulation: Encouraging patients to get out of bed and move as soon as possible after surgery to prevent complications such as blood clots and respiratory issues.
Optimized Fluid Management: Employing strategies to avoid overhydration and maintain optimal fluid balance during and after surgery.
Minimized Use of Drains and Tubes: Limiting the use of drains and tubes to reduce discomfort and complications.
Standardized Surgical Techniques: Implementing evidence-based surgical approaches to minimize tissue trauma and accelerate recovery.
Postoperative Nutrition: Providing adequate nutrition after surgery to support healing and recovery.
Early Oral Intake: Encouraging the resumption of oral intake as soon as possible after surgery to prevent complications and promote recovery.
Postoperative Monitoring: Implementing protocols for regular monitoring of vital signs and early detection of complications.
Patient Engagement: Engaging patients in their care, encouraging them to be active participants in the recovery process.
ERAS protocols are typically multidisciplinary, involving collaboration among surgeons, anesthesiologists, nurses, and other healthcare professionals. The implementation of ERAS has been associated with reduced postoperative complications, shorter hospital stays, and faster recovery for patients undergoing various surgical procedures, including colorectal surgery, joint replacement, and abdominal surgery. The specific elements of ERAS may vary based on the type of surgery and the healthcare institution's protocols.