Enhanced Recovery After Surgery - ERAS

What is ERAS?

• An evidenced-based care pathway designed to shorten recovery and improve outcomes after abdominal colon and rectal surgery
• There are many components of the program:
  • Pre-operative measures-things we ask you, the patient to do before surgery
  • Intra-operative measures-techniques used in the operating room to speed your recovery
  • Post-operative measures-care plans in the hospital after surgery to speed your recovery
• Dr. Jeffrey Manchio had a critical role in designing this program at Providence St. Vincent Hospital that is used by all our surgeons

Why do we use ERAS?

• Fewer complications
• Less pain
• Improved patient experience
• Shorter length of hospital stay after surgery
• Cost reduction
• All without increased readmissions or ER visits!

Pre-operative Components

• Smoking cessation if possible
• Blood sugar control
• Nutrition Optimization
  • Impact (a nutrition drink) for 5 days prior to surgery
  • Clear liquids or Boost Breeze until 2-4 hours before arrival for surgery
• Pain medication
• Entereg-a medication to help your colon recover from surgery

Intra-operative Components

• Local anesthesia to block pain fibers
• Prevention of nausea
• Fluid management
• Minimally invasive surgery
• No nasogastric tube

Post-operative Components

• Clear liquids and advancing diet as tolerated
• Walking in the halls
• Tylenol
• Narcotics only as needed
• Entereg
• Early discharge