Table 1.

Summary of elements in an enhanced recovery after surgery (ERAS) programme applicable to liver surgery

Evidence-based factors	Probably useful factors
No oral bowel preparation	Preoperative counselling
Preoperative feeding: carbohydrate loading up to 2 h before surgery	Provision of i.v. analgesia
No pre-anaesthetic medication	Stimulation of bowel movement with laxatives
Anti-thrombotic prophylaxis	Early and scheduled mobilization
Single-dose antibiotics	Audit
Epidural analgesia
Prevention of postoperative nausea and vomiting
Avoidance of hypothermia
No routine drainage of peritoneal cavity
No postoperative nasogastric intubation
Good fluid balance
Removal of urinary catheter on day 1
Normal food at will after surgery from day 1

Evidence-based factors: separate items are graded as being supported by level 1 or level 2 evidence (according to the guidelines of the Oxford Centre for Evidence-Based Medicine¹³).

Probably useful factors: evidence is less strong, but these factors are felt to be useful because the items are most probably quality-enhancing, are associated generally with a low incidence of adverse effects and low costs.