Table 1 Nonstrict and individual ERAS program in our center
From: Nonstrict and individual enhanced recovery after surgery (ERAS) in partial hepatectomy
ERAS element in our center | |
|---|---|
Day before surgery | |
Preoperative information about ERAS | An inform of ERAS with good mood |
Preoperative bowl preparation | No enema |
Preoperative fasting | Normal oral nutrition until midnight; carbohydrate drink up to 2 h before surgery |
Premedication | Omission as possible |
Day of surgery | |
Nasogastric tubes | Removed at the end of surgery |
Anesthesia | General anesthesia combined with epidural anesthesia, with low dose of epidural analgesia in 2 days |
Hypothermia | Prevention hypothermia |
Fluid therapy | “Restrict fluid regimen”, avoid excessive i.v. fluids (CVP <5 mmHg), appropriate vasoconstrictor instead |
Day after surgery | |
Drainage of peritoneal cavity | No, or remove on day 1 |
Laxative | Start laxative (lactulose oral solution 30 mg) from day 1 |
Urinary catheter | No, or removed <24 h |
Oral liquid take | Drink about 0.5 L liquid on day 1; at least 1 L liquid on day 2; normal diet from day 3 |
Postoperative analgesia | Flurbiprofen, tramadol in 2 days, followed with NSAID’s |
Mobilization | Promote in bed on day 1, a minimum of four times per day; enforced mobilization from day 2 |