Table 2.
Perioperative care ERP interventions and definition of adherence
| Preoperative | |
| Preadmission education | Patient received preoperative counselling from a nurse and a physician, and a dedicated booklet including information on recovery goals and expectation about hospital stay. |
| Selective MBP | No MBP used for resection. |
| Carbohydrate loading | Preoperative carbohydrate intake until 2 h before anaesthesia (50 g carbohydrate in 400 mL fluid). |
| No long-acting sedation | No long-acting sedating medication used before surgery (e.g., opioids, antihistamines, benzodiazepines). |
| Intraoperative | |
| Antibiotic prophylaxis | Antibiotic prophylaxis completed prior to surgical incision |
| IV Lidocaine | Continuous infusion: 1.5 mg/kg/h from the beginning to the end of surgery. |
| Laparoscopic approach | Successfully completed laparoscopic resection. |
| Zero Fluid Balanced | Intraoperative maintenance fluids, excluding replacement of blood loss: for laparoscopy: 3 ml/kg/h; for open surgery: 5 ml/kg/h. |
| PONV | Multimodal prophylaxis administered, with at least to drugs including Dexamethasone. |
| No abdominal or pelvic drainage | No resection-site drainage used. |
| Normothermia | Body temperature measured at the end of surgery >36.0 _C. |
| Preventive Opioid-sparing Multimodal | Acetaminophen, NSAIDs (unless complication), Nefopam: IV first dose administered intraoperatively. |
| Analgesia | Loco-regional analgesia performed (injection at incision site or bilateral TAP block). |
| Postoperative | |
| Opioid-sparing multimodal analgesia | Use of opioid-sparing strategies including, abdominal trunk block and oral analgesia: acetaminophen, NSAIDs (unless complication), Level II opioids. |
| Free diet on POD 0 | Patient received one meal with regular food by POD 0. |
| Early mobilization out of bed on POD0 | Patient mobilized out of bed after surgery by POD 0. |
| Early ablation of IV fluid infusion | Ablation of intravenous fluid infusion by POD 0. |
| Early removal of urinary drainage | Removal of urinary catheter by POD 1. |
| TED prophylaxis | TED prophylaxis with low molecular weight heparin. |
| Avoidance of nasogastric tube | Nasogastric tube removed at the end of general anaesthesia. |
Abbreviations: MBP mechanical bowel preparation, PONV prevention of nausea and vomiting