Table 1.

Protocol measures—pediatric oncology recovery after tumor surgery (PORTS) study.

	Process measure	Goal
Preoperative	Counsel about ERAS	Set expectations via handout + pre-operative checklist either by phone or in clinic
	Carbohydrate load	10 ml/kg (up to 350 ml) ClearFast or RecoverAid (alt: Gatorade, PowerAde, Pedialyte) between 1 and 2 h scheduled start time. Omit if <6 months age.
	Avoid prolonged fasting	Regular diet night before, no prolonged clear liquid diet
	No bowel preparation
	Antibiotic prophylaxis	Case-appropriate within 60 min prior to incision
Intraoperative	Regional anesthesia	Pre-incision epidural, TAP, QL, or ESP catheters preferred
	Avoiding excess drains	No intraperitoneal or subcutaneous drains
	Euvolemia	3–7 ml/kr/h crystalloid and colloid fluids (over OR time)
	Normothermia	36°C–38°C during skin-to-skin time
	Minimizing Opioids	≤0.3 mg/kg IV milligram morphine equivalents
	DVT prophylaxis	SCDs prior to induction for patients ≥10 years
	Minimally invasive approach	Laparoscopic or robotic as oncologically feasible
Postoperative	No nasogastric tube	Remove prior to leaving OR if used
	Nausea/vomiting prophylaxis	PRN ondansetron, diphenhydramine, scopolamine, etc.
	Early feeding	Clears on POD#0, regular diet by POD#1
	Early mobilization	Out of bed by POD#1
	Postoperative non-opioid pain regimen	Scheduled acetaminophen and NSAID (ketorolac, ibuprofen); Avoid NSAID if CKD 2+, allergy
	Early removal of IV fluids	By POD#1
	Early removal of drains	As early as possible, Foley removal at time of epidural removal, if applicable
	Minimizing opioids	≤0.15 mg/kg IV milligram morphine equivalents per day

POD, post-operative day; NSAID, non-steroidal anti-inflammatory drugs; CKD, chronic kidney disease; TAP, transversus abdominus plane; QL, quadratus lumborum; ESP, erector spinae plane.