Enhanced Recovery After Surgery

The following chapter delves into the changes in the perioperative care of the patients in order to decrease the surgical stress response and facilitate early postoperative recovery. These care bundles, termed as the enhanced recovery after surgery (ERAS) protocols, operate during the preoperative, intraoperative and postoperative period. Many traditional perioperative protocols such as prolonged preoperative fasting, mechanical bowel preparation, use of drains and nasogastric tubes, prolonged bed rest and delayed postoperative enteral feeding, are challenged in the new set of guidelines. All the changes adopted in the newer protocols have shown to improve the clinical outcomes in the surgical patients as well as cost benefits to the healthcare system. Coordination between the healthcare providers namely, the surgeons, anesthetists, nurses and the paramedical staff forms the backbone for successful implementation of these protocols.