Enhanced Recovery After Surgery (ERAS) Recommendations

The objectives of enhanced recovery after surgery (ERAS) are to lower hospital length of stay, enhance patient outcomes, and save costs. ERAS interventions are used before, during, and after surgery. Preoperative patient and family education, nutritional status optimization, and antimicrobial prophylaxis all lead to better results. Regional anesthesia, multimodal analgesia, and opioid-sparing strategies all speed up recovery. Postoperative early nutrition and rehabilitation are all factors related to a successful ERAS program. However, ERAS protocol is not good for all patients. There are some predictors of possible ERAS program failure as renal failure, hypertension, age, abnormal EuroSCORE, cardiopulmonary bypass time, first lactate or base excess deficit after surgery, and aortic cross-clamping time. The objective of this chapter is to provide a guidance for conducting an ERAS program by identifying all the essential elements in the pre-, intra-, and postoperative phase, trying to provide the clinicians with useful and necessary tools to implement an ERAS program.