Enhanced recovery after surgery(2024).pptx

ERAS protocol

1. ENHANCED RECOVERY AFTER SURGERY ( ERAS ) PRESENTATION BY : DR.SANJITH, PGY-1 , GENERAL SURGERY

2. WHAT IS ERAS? Initiated by Professor Henrik Kehlet in the 1990s ,  ERAS, enhanced recovery programs (ERPs) or “fast-track” programs have become an important focus of perioperative management. These programs attempt to modify the physiological and psychological responses to major surgery  and have been shown to lead to a reduction in complications and hospital stay, improvements in cardiopulmonary function, earlier return of bowel function and earlier resumption of normal activities

3. Enhanced recovery after surgery (ERAS) protocols are multimodal perioperative care pathways designed to achieve early recovery after surgical procedures by maintaining pre-operative organ function and reducing the profound stress response following surgery

4. PRE - OP INTRA - OP POST - OP COMPONENTS OF ERAS

5. PRE - OPERATIVE PATIENT EDUCATION AND PRE ADMISSION COUNSELLING CARBOHYDRATE LOADING NO PROLONGED FASTING AVOID BOWEL PREPARATION NAUSEA AND VOMITTING PROPHYLAXIS THROMBOPROPHYLAXIS

6. INTRA - OPERATIVE MINIMALLY INVASIVE SURGERY REGIONAL ANAESTHESIA NORMOTHERMIA NO DRAINS MULTIMODAL PAIN MANAGEMENT SHORT ACTING ANAESTHETICS

7. POST – OPERATIVE EARLY MOBILIZATION EARLY ENTERAL FEEDING NO NG TUBES EARLY URINARY CATHETER REMOVAL MULTIMODAL PAIN MANAGEMENT NAUSEA AND VOMITTIN PROPHYLAXIS

8. GOALS OF ERAS REDUCTION OF STRESS RESPONSE TO SURGERY ACCELERATION OF RECOVERY DECREASED LENGTH OF HOSPITAL STAY DECREASED POST OPERATIVE MORTALITY AND MORBIDITY REDUCTION OF THE RATE OF RE-ADMISSIONS FOLLOWING SURGERY

9. MEMBERS OF THE ERAS TEAM SURGEONS NURSES ANAESTHESIOLOGISTS OCCUPATIONAL THERAPIST PAIN MANAGEMENT SPECIALIST PHYSIOTHERAPIST DIETICIAN HOSPITAL MANAGEMENT AUDIT TEAM

10. ERAS IN MODERN SURGICAL PRACTICE

11. IN COLORECTAL SURGERY (ELECTIVE)

12. IN EMERGENCY LAPAROTOMY

13. IN GYNECOLOGICAL SURGERY

14. IN CARDIO-THORACIC SURGERY

15. IN UROLOGICAL SURGERY