Enhanced recovery after surgery (eras)
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Enhanced Recovery After Surgery (ERAS) aims to optimize patient outcomes and reduce costs through a multimodal perioperative care approach. Traditionally, patients followed principles like prolonged preoperative fasting, use of nasogastric tubes, and long periods of bed rest after surgery. ERAS instead focuses on evidence-based best practices like early mobilization, regional anesthesia, and maintaining normothermia and fluid balance. By avoiding unnecessary dogmas and optimizing the patient's health before and after surgery through a team-based approach, ERAS can provide benefits like shorter hospital stays, less pain and complications, and faster recovery.
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Enhanced recovery after surgery (eras)
The ERAS protocol was developed in 2001 to improve surgical recovery through evidence-based practices. It utilizes a multidisciplinary team and multimodal interventions including preoperative education and carbohydrate loading, intraoperative fluid management and opioid-sparing techniques, and postoperative early nutrition, ambulation and defined discharge criteria. Implementation of ERAS has been shown to reduce length of hospital stay by 35-40% and complications rates while lowering healthcare costs. While initially developed for colorectal surgery, ERAS has been applied to other specialties and demonstrated benefits but faces barriers to widespread adoption including resistance to changing traditional practices.
Eras protocol (3)
The document outlines the Enhanced Recovery After Surgery (ERAS) protocol. ERAS aims to reduce surgical stress, accelerate recovery through a multimodal approach. Key elements of ERAS include pre-admission counseling and nutrition optimization, minimizing preoperative fasting through carbohydrate loading, selective bowel preparation if needed, thoracic epidural anesthesia, early feeding and mobilization, and multimodal pain control to avoid opioid use and ileus. The goal is to minimize length of stay through evidence-based perioperative optimization.
ERAS Protocol
The document discusses the Enhanced Recovery After Surgery (ERAS) protocol. ERAS aims to optimize patient care and recovery through a multidisciplinary, evidence-based approach. It challenges traditional practices like prolonged preoperative fasting and use of drains. The ERAS protocol incorporates recommendations across the preoperative, intraoperative and postoperative periods. This includes carbohydrate loading, minimal fasting, optimized fluid management, multimodal analgesia, early nutrition and mobilization to reduce complications and length of stay while improving outcomes.
Enhanced recovery after surgery
This document provides guidelines for perioperative care in elective colorectal surgery as part of an Enhanced Recovery After Surgery (ERAS) protocol. It makes recommendations for several preadmission items including preadmission counselling and education, preoperative optimization of medical conditions, prehabilitation, preoperative nutrition, management of anemia, and prevention of postoperative nausea and vomiting. The recommendations are based on reviews of the available evidence and are intended to reduce complications and facilitate early recovery after colorectal surgery.
Enhanced Recovery After Surgery
This document discusses Enhanced Recovery Programs (ERPs), which aim to reduce stress response to surgery and accelerate recovery through a multimodal perioperative care pathway. Key elements of ERPs include preoperative counseling and carbohydrate loading, avoiding mechanical bowel preparation and nasogastric tubes, use of thoracic epidurals, short-acting anesthetics, goal-directed fluid therapy, normothermia, short incisions or laparoscopy, early oral intake and mobilization, and clear discharge criteria focused on independence rather than length of stay. Strict adherence to an ERP can reduce typical hospital stays for major colorectal surgery from 7-14 days to 2-3 days. ERPs require a multidisciplinary team
Using Enhanced Recovery After Surgery (ERAS) to Enhance Postoperative Outcomes
Speaker: Francesco Carli, MD, MPhil, senior staff anesthesiologist at the McGill University Health Centre
Cost: Complimentary, sponsored by Wellbe
There is strong evidence that many of aspects of surgical care have little evidence, and therefore the Enhanced Recovery After Surgery (ERAS) program has been set up to accelerate the recovery process and decrease the rate of postoperative complications. There is an opportunity to improve outcomes by using team approach and revision of the standard procedures.
Learn about:
– The elements of ERAS protocols
– How to structure the Team approach
– The role of the patient in ERAS
– How to perform an audit of your program
About the Speaker:
Francesco Carli, MD, MPhil, is Professor of Anesthesia at McGill University and Associate Professor in the School of Dietetics and Human Nutrition at McGill University and a senior staff anesthesiologist at the McGill University Health Centre. He is currently an Elected Member of the American Academy of Anesthesia and a Board Member of the Enhanced Recovery After Surgery (ERAS) Society. Dr. Carli completed his medical training and anesthesia training in Turin, Italy, Paris, France, and London, England. He completed a Master’s Degree in surgical metabolism at the University of London, England.
His research interests are: metabolic changes associated with surgery and the impact of perioperative interventions (regional analgesia, nutrition, hormones, exercise) on postoperative recovery; evaluation of functional outcome measures during the surgical recovery process; prehabilitation of surgical patients. He is the author of over 250 peer-review scientific articles and has been a recipient of over 50 peer and non peer-review grants.
Enhanced Recovery after Surgery its relevance - Evidence Based
Enhanced recovery programs are evidence-based protocols designed to standardize medical care, improve outcomes, and lower health care costs. These protocols include evidence-based techniques to minimize surgical trauma and postoperative pain, reduce complications, improve outcomes, and decrease hospital length of stay, while expediting recovery following elective procedures.Protocols have been developed for colorectal surgery patients to reduce physiological stress and postoperative organ dysfunction through optimization of perioperative care and recovery
Eras
The document discusses Enhanced Recovery After Surgery (ERAS) protocols. It describes how ERAS aims to reduce surgical stress on patients through multimodal perioperative care, facilitating early recovery. This includes optimizations in pre-, intra-, and postoperative care such as shortened fasting times, carbohydrate loading, minimized fluid administration, and early mobilization. The document provides examples of procedures that can be done as day surgeries and details the key elements of ERAS protocols.
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Enhanced recovery after surgery (eras)
The ERAS protocol was developed in 2001 to improve surgical recovery through evidence-based practices. It utilizes a multidisciplinary team and multimodal interventions including preoperative education and carbohydrate loading, intraoperative fluid management and opioid-sparing techniques, and postoperative early nutrition, ambulation and defined discharge criteria. Implementation of ERAS has been shown to reduce length of hospital stay by 35-40% and complications rates while lowering healthcare costs. While initially developed for colorectal surgery, ERAS has been applied to other specialties and demonstrated benefits but faces barriers to widespread adoption including resistance to changing traditional practices.
Eras protocol (3)
The document outlines the Enhanced Recovery After Surgery (ERAS) protocol. ERAS aims to reduce surgical stress, accelerate recovery through a multimodal approach. Key elements of ERAS include pre-admission counseling and nutrition optimization, minimizing preoperative fasting through carbohydrate loading, selective bowel preparation if needed, thoracic epidural anesthesia, early feeding and mobilization, and multimodal pain control to avoid opioid use and ileus. The goal is to minimize length of stay through evidence-based perioperative optimization.
ERAS Protocol
The document discusses the Enhanced Recovery After Surgery (ERAS) protocol. ERAS aims to optimize patient care and recovery through a multidisciplinary, evidence-based approach. It challenges traditional practices like prolonged preoperative fasting and use of drains. The ERAS protocol incorporates recommendations across the preoperative, intraoperative and postoperative periods. This includes carbohydrate loading, minimal fasting, optimized fluid management, multimodal analgesia, early nutrition and mobilization to reduce complications and length of stay while improving outcomes.
Enhanced recovery after surgery
This document provides guidelines for perioperative care in elective colorectal surgery as part of an Enhanced Recovery After Surgery (ERAS) protocol. It makes recommendations for several preadmission items including preadmission counselling and education, preoperative optimization of medical conditions, prehabilitation, preoperative nutrition, management of anemia, and prevention of postoperative nausea and vomiting. The recommendations are based on reviews of the available evidence and are intended to reduce complications and facilitate early recovery after colorectal surgery.
Enhanced Recovery After Surgery
This document discusses Enhanced Recovery Programs (ERPs), which aim to reduce stress response to surgery and accelerate recovery through a multimodal perioperative care pathway. Key elements of ERPs include preoperative counseling and carbohydrate loading, avoiding mechanical bowel preparation and nasogastric tubes, use of thoracic epidurals, short-acting anesthetics, goal-directed fluid therapy, normothermia, short incisions or laparoscopy, early oral intake and mobilization, and clear discharge criteria focused on independence rather than length of stay. Strict adherence to an ERP can reduce typical hospital stays for major colorectal surgery from 7-14 days to 2-3 days. ERPs require a multidisciplinary team
Using Enhanced Recovery After Surgery (ERAS) to Enhance Postoperative Outcomes
Speaker: Francesco Carli, MD, MPhil, senior staff anesthesiologist at the McGill University Health Centre
Cost: Complimentary, sponsored by Wellbe
There is strong evidence that many of aspects of surgical care have little evidence, and therefore the Enhanced Recovery After Surgery (ERAS) program has been set up to accelerate the recovery process and decrease the rate of postoperative complications. There is an opportunity to improve outcomes by using team approach and revision of the standard procedures.
Learn about:
– The elements of ERAS protocols
– How to structure the Team approach
– The role of the patient in ERAS
– How to perform an audit of your program
About the Speaker:
Francesco Carli, MD, MPhil, is Professor of Anesthesia at McGill University and Associate Professor in the School of Dietetics and Human Nutrition at McGill University and a senior staff anesthesiologist at the McGill University Health Centre. He is currently an Elected Member of the American Academy of Anesthesia and a Board Member of the Enhanced Recovery After Surgery (ERAS) Society. Dr. Carli completed his medical training and anesthesia training in Turin, Italy, Paris, France, and London, England. He completed a Master’s Degree in surgical metabolism at the University of London, England.
His research interests are: metabolic changes associated with surgery and the impact of perioperative interventions (regional analgesia, nutrition, hormones, exercise) on postoperative recovery; evaluation of functional outcome measures during the surgical recovery process; prehabilitation of surgical patients. He is the author of over 250 peer-review scientific articles and has been a recipient of over 50 peer and non peer-review grants.
Enhanced Recovery after Surgery its relevance - Evidence Based
Enhanced recovery programs are evidence-based protocols designed to standardize medical care, improve outcomes, and lower health care costs. These protocols include evidence-based techniques to minimize surgical trauma and postoperative pain, reduce complications, improve outcomes, and decrease hospital length of stay, while expediting recovery following elective procedures.Protocols have been developed for colorectal surgery patients to reduce physiological stress and postoperative organ dysfunction through optimization of perioperative care and recovery
Eras
The document discusses Enhanced Recovery After Surgery (ERAS) protocols. It describes how ERAS aims to reduce surgical stress on patients through multimodal perioperative care, facilitating early recovery. This includes optimizations in pre-, intra-, and postoperative care such as shortened fasting times, carbohydrate loading, minimized fluid administration, and early mobilization. The document provides examples of procedures that can be done as day surgeries and details the key elements of ERAS protocols.
Dr sunil eras
Enhanced Recovery After Surgery (ERAS) is a multidisciplinary approach to perioperative care designed to reduce surgical stress, accelerate recovery, and shorten hospital stays. Key elements include preoperative education and counseling, no mechanical bowel prep, carbohydrate loading before surgery, short-acting anesthesia, minimizing fluids and tubes, early feeding and mobilization, multimodal pain control to reduce opioids, and clear discharge criteria. Implementing ERAS has been shown to reduce complications by 50% and shorten hospital stays by 30% compared to traditional care pathways.
ERAS
ERAS (Enhanced Recovery After Surgery) is a collection of evidence-based practices designed to improve recovery after major surgery. The goals are to reduce surgical stress, maintain normal physiologic function, and enhance early mobilization. ERAS emphasizes preoperative education, minimizing fasting times, multimodal pain control, early feeding and mobilization to reduce length of stay, complications, and costs while improving patient satisfaction. It was first developed in the 1990s and involves protocols tailored for specific surgeries like gynecologic procedures.
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This document outlines the components of an Enhanced Recovery After Surgery (ERAS) protocol presented by Dr. Sanjay Dange. The goals of ERAS are to decrease postoperative stress, maintain physiological function, and enable early mobilization to reduce recovery time and length of stay without increasing complications. Key elements include preoperative education and optimization, minimally invasive surgery when possible, goal-directed fluid management, multimodal analgesia including epidural anesthesia, early feeding and mobilization within 24 hours of surgery.
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This document provides an overview of enhanced recovery after surgery (ERAS) protocols. It discusses the history and phases of ERAS, including preoperative, intraoperative, and postoperative considerations. Specifically, it outlines strategies to optimize patient nutrition and exercise preoperatively, prevent hypothermia and infections intraoperatively, and promote early mobilization postoperatively. The overall goal of ERAS is to implement a multimodal, evidence-based approach to accelerate patient recovery through the perioperative period.
Enhanced Recovery Canada Presentation
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Learn more about Enhanced Recovery Canada:
http://ow.ly/hR3j30jsnjR
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The document discusses enhanced recovery after surgery (ERAS) programs. It describes how ERAS utilizes a multimodal approach involving surgeons, nurses, dietitians and others to optimize patient care and recovery through measures like preoperative counseling and nutrition, minimal invasive surgery when possible, reduced use of tubes/drains, early mobilization and feeding, and well-managed postoperative pain control. The goal is to reduce length of stay without increasing complications through evidence-based practices compared to traditional postoperative care methods. Studies show ERAS programs can achieve these outcomes safely and cost-effectively across several surgery types.
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- How enhanced recovery aims to get patients recovering sooner by preparing them before surgery and providing standardized post-operative care and early mobilization.
- Evidence that enhanced recovery pathways improve patient experience and outcomes like reduced length of hospital stay while increasing day-of-surgery admissions without increasing readmissions.
- Future goals of expanding enhanced recovery principles to non-elective care and developing systems to better risk-stratify patients and optimize their fitness before surgery.
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Enhanced Recovery After Surgery (ERAS) is a multidisciplinary approach to perioperative care designed to reduce surgical stress, accelerate recovery, and shorten hospital stays. Key elements include preoperative education and counseling, no mechanical bowel prep, carbohydrate loading before surgery, short-acting anesthesia, minimizing fluids and tubes, early feeding and mobilization, multimodal pain control to reduce opioids, and clear discharge criteria. Implementing ERAS has been shown to reduce complications by 50% and shorten hospital stays by 30% compared to traditional care pathways.
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ERAS (Enhanced Recovery After Surgery) is a collection of evidence-based practices designed to improve recovery after major surgery. The goals are to reduce surgical stress, maintain normal physiologic function, and enhance early mobilization. ERAS emphasizes preoperative education, minimizing fasting times, multimodal pain control, early feeding and mobilization to reduce length of stay, complications, and costs while improving patient satisfaction. It was first developed in the 1990s and involves protocols tailored for specific surgeries like gynecologic procedures.
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This document provides an overview of enhanced recovery after surgery (ERAS) protocols. It discusses the history and phases of ERAS, including preoperative, intraoperative, and postoperative considerations. Specifically, it outlines strategies to optimize patient nutrition and exercise preoperatively, prevent hypothermia and infections intraoperatively, and promote early mobilization postoperatively. The overall goal of ERAS is to implement a multimodal, evidence-based approach to accelerate patient recovery through the perioperative period.
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http://ow.ly/hR3j30jsnjR
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Post operative pain management
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Laparoscopy involves using small incisions and a camera to visualize the inside of the abdomen. It has several advantages over open surgery such as less pain, shorter hospital stays, and quicker recovery times. Some of the key equipment used in laparoscopy include rod lens systems and fiber optic cables for optics, trocars for abdominal access, and insufflators to inflate the abdomen with gas. Potential risks include injuries from trocars or pneumoperitoneum as well as effects of the pneumoperitoneum on respiratory and renal systems. Common procedures now performed laparoscopically include cholecystectomy, appendisectomy, hernia repair, and some cancer staging.
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Effect of the Enhanced Recovery After Surgery (ERAS)
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Enhanced recovery care pathways
This document summarizes an enhanced recovery care pathway for patients undergoing surgery. It discusses:
- The key components of enhanced recovery pathways for thoracic surgery, maternity care, and medicine based on experiences at various hospitals.
- How enhanced recovery aims to get patients recovering sooner by preparing them before surgery and providing standardized post-operative care and early mobilization.
- Evidence that enhanced recovery pathways improve patient experience and outcomes like reduced length of hospital stay while increasing day-of-surgery admissions without increasing readmissions.
- Future goals of expanding enhanced recovery principles to non-elective care and developing systems to better risk-stratify patients and optimize their fitness before surgery.
The role of the ERAS society
Olle Ljungqvist discussed improving perioperative care worldwide through the ERAS Society. He summarized evidence showing variations in outcomes between countries and hospitals, and how implementing ERAS guidelines can reduce variations and complications. Sustaining ERAS requires a multidisciplinary team approach, ongoing training, and continuous auditing to maintain compliance over time. While complex to implement initially, ERAS has been shown to reduce costs and complications globally when properly established.
Day case surgery
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Minimally invasive surgery
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This document discusses enhanced recovery after surgery (ERAS), which aims to help patients recover faster and return to normal function after major surgery. It involves a multidisciplinary team optimizing all aspects of care, from pre-admission counseling to postoperative mobilization. Key elements include preoperative carbohydrate drinks, minimally invasive surgery when possible, epidural analgesia, early oral intake and mobilization to avoid complications and shorten hospital stays. ERAS has been shown to result in quicker recovery, more efficient use of resources, and similar or lower complication rates compared to traditional care.
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This document discusses enhanced recovery after surgery (ERAS), which aims to help patients recover faster and return to normal function after major surgery. It outlines the key elements of an ERAS protocol, which includes preoperative counseling and carbohydrate drinks before surgery, multimodal pain relief without opioids, early oral intake and mobilization after surgery, and clear discharge criteria focused on independence rather than length of stay. ERAS requires collaboration between medical professionals and has been shown to reduce costs and resource use while maintaining low complication rates.
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The document provides tips for using a PowerPoint presentation. It recommends:
1) Freely downloading, editing, and modifying the slides and adding your name.
2) Using blank slides to engage students by asking questions before providing answers.
3) Repeating the process of blank slide, student response, answer slide three times for active learning.
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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.
- 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.
- 8. AIMS
- 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
- 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.
- 25. THANK YOU.