Enhanced Recovery After Surgery (ERAS)

Question 1

What three stages of patient journey is the ERAS protocol divided into?

Answer 1

Pre-op

Intra-op

Post-op

Question 2

Explain Pre-op ERAS

Answer 2

Patient education

Ensure the patient is as healthy as possible

Optimise medical management (includes smoking and alcohol cessation)

Optimal pre-op fasting guidelines

Question 3

Optimal pre-op fasting guidelines

Answer 3

Altered diet prior to enhance bowel recovery and avoid bowel prep if appropriate

Solids allowed unti 6h pre op

Intake of clear fluids until 2h prior

Loading with 12.5% carbohydrate beverage within 2 hours of surgery

Question 4

Intra-op ERAS

Answer 4

Multimodal and opioid sparing analgesia

Use of multimodal post-op N+V prophylaxis

Use of minimally invasive surgery

Goal-directed fluid therapy regime

Question 5

Post-op ERAS

Answer 5

Adequate pain control

Early oral intake

Early mobilisation

MDT post-op patient follow-up