Table 1.
Preoperative | Pre-admission counseling |
Stopping smoking and alcohol abuse | |
Optimize nutrition and glucose control | |
No oral bowel preparation | |
Intra-operative | Preoperative carbohydrate loading |
Avoiding sedative premedication | |
Thromboembolism and antimicrobial prophylaxis | |
Epidural or other regional anesthesia | |
Balanced fluid therapy avoiding overhydration | |
Active warming | |
Minimally invasive surgery | |
PONV prophylaxis | |
No abdominal drains or nasogastric drains | |
Postoperative | Multimodal analgesia to avoid opioids |
Early removal of urinary catheter | |
Early oral feeding and intense mobilization | |
No intravenous infusions | |
Support of GI function (laxatives/prokinetics) | |
Nutritional supplements | |
Audit |
PONV: Postoperative nausea and vomiting; GI: Gastrointestinal.