enhanced recovery after surgery

1. ERAS
“ENHANCED
RECOVERY AFTER
SURGERY”
dr. M. Arief Kurniawan, SpAn, FIP
SMF Anestesi, Terapi Intensif dan Manajemen Nyeri
RSU Hasanah Graha Afiah

2. WHAT IS ENHANCED
RECOVERY AFTER
SURGERY?
A History

3. ERAS
(ENHANCED
RECOVERY
AFTER
SURGERY)
Fast-track Programs
Enhanced Recovery Programs – ERP
Programs which attempt to modify
physiological and psychological
responses to major surgery

4. Goal of ERASProgram
Safe and comfortable
• Allow early return to daily living asap
• Decrease the incidence and severity of
perioperative complications
• Reduce postop readmission rates
• Reduction in length of stay
• Reduce healthcare costs without compromising
patient care
• Improve patient satisfaction
Scot MJ, Miller TE. Anesthesiology Clin 33 (2015) 79–91

11. What are factors that influence
surgical outcome ?
Surgical
Nurse
care
Perioperative
Anesthesia
management management
QUALITYOFP
A
TIENTCARE OUTCOME
Patient’s factors
• Severity of diseases
• Comorbid
• Age
Healthcare random variation • Complication
• Quality of life

12. Intraoperative Items
Gustafsson UO, Scott MJ, Hubner M, Nygren J, Demartines N, Francis N, Rockall TA, Young-Fadok TM, et.al.
Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERASÒ)
Society Recommendations: 2018 . World Journal of Surgery. 2018

13. ANALGETIK POST OP
- ketorolac 3x30mg iv + PCT 4x1 gr po
- TAP block + ketorolac 3x30mg iv
- CBI