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Enhanced Recovery
After Surgery (ERAS)
NIKHIL PANJIYAR
BMC,1ST BATCH.
MODERATOR : DR.NISESH SITAULA
THE DOGMA
• “A principle or set of principles laid down by authority as inconvertibly
true”
• DOGMAS in General Surgery: Preoperative prolonged fasting
MBP
Nasogastric tube
Drains
Prolonged bedrest.
Introduction
• This concept was first described in 1990s by Henrick Kehlet, surgical
gastroenterologist.
• Consist of a Enhanced Recovering Programs which is a multimodal
perioperative care developed with a goal of maintaining normal
physiology ,thus optimizing patient outcomes
• It is designed to speed clinical recovery of the patient and reduce
both the cost and the length of stay of the patient in the hospital.
• It is achieved by optimizing the health of the patient before surgery
through prehabilitation and then delivering evidence-based best care
in the perioperative period.
AIMS
PRINCIPLES OF ERAS
 Preoperative counseling and nutritional strategies , including avoidance of
prolonged perioperative fasting.
 Perioperative considerations, including a focus on regional anesthesia and
non-opoid analgesic approaches ,fluid balance and maintainance of
normothermia.
 Promotion of postoperative strategies ,including early mobilization and
appropriate thrombo-prophylaxis.
TEAM MEMBERS
 Nurses
 Dietician
 Physiotherapist
 Anaesthiologist
 Surgeons
 Hospital management
 Audit team
BENEFITS OF ERAS PATHWAYS
• Shorter length of hospital stay
• Decreased post operative pain and need for analgesia
• More rapid return of bowel function
• Decrease complication and readmission rates
• Increased patient satisfaction
References…
• Bailey & love’s short text book of surgery-27th edition
• Mayo’s enhanced recovery after surgery 2019 protocol.
THANK YOU.

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Enhanced recovery after surgery (eras)

  • 1. Enhanced Recovery After Surgery (ERAS) NIKHIL PANJIYAR BMC,1ST BATCH. MODERATOR : DR.NISESH SITAULA
  • 2. THE DOGMA • “A principle or set of principles laid down by authority as inconvertibly true” • DOGMAS in General Surgery: Preoperative prolonged fasting MBP Nasogastric tube Drains Prolonged bedrest.
  • 3.
  • 4. Introduction • This concept was first described in 1990s by Henrick Kehlet, surgical gastroenterologist. • Consist of a Enhanced Recovering Programs which is a multimodal perioperative care developed with a goal of maintaining normal physiology ,thus optimizing patient outcomes
  • 5. • It is designed to speed clinical recovery of the patient and reduce both the cost and the length of stay of the patient in the hospital. • It is achieved by optimizing the health of the patient before surgery through prehabilitation and then delivering evidence-based best care in the perioperative period.
  • 6.
  • 7.
  • 9. PRINCIPLES OF ERAS  Preoperative counseling and nutritional strategies , including avoidance of prolonged perioperative fasting.  Perioperative considerations, including a focus on regional anesthesia and non-opoid analgesic approaches ,fluid balance and maintainance of normothermia.  Promotion of postoperative strategies ,including early mobilization and appropriate thrombo-prophylaxis.
  • 10. TEAM MEMBERS  Nurses  Dietician  Physiotherapist  Anaesthiologist  Surgeons  Hospital management  Audit team
  • 11.
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23. BENEFITS OF ERAS PATHWAYS • Shorter length of hospital stay • Decreased post operative pain and need for analgesia • More rapid return of bowel function • Decrease complication and readmission rates • Increased patient satisfaction
  • 24. References… • Bailey & love’s short text book of surgery-27th edition • Mayo’s enhanced recovery after surgery 2019 protocol.