Table 1.

Evidence-based alternatives to epidural analgesia in the setting of ERAS.

Type of Surgery	Preoperative Analgesia	Intraoperative Analgesia	Postoperative Analgesia
Open colorectal cancer surgery Bertoglio et al., 2012 [25]	None	Fentanyl 2–5 mcg/kg/h	Ropivacaine 0.2% 10 mL/h through preperitoneal catheter (above the peritoneum within the musculofascial layer) Ketolorac 30 mg × 3 IV Acetaminophen 1 g × 4 PO
Open gynaecology/oncology surgery Kalogera et al., 2013 [26]	Celecoxib 400 mg × 1 PO Acetaminophen 1 g × 1 PO Gabapentin 600 mg × 1 PO	Opioids IV at discretion of anesthesiologist supplemented with ketamine, ketorolac, or both. After incision closure: injection of bupivacaine at incision site	Oxycodone 5–10 mg as required PO, max 6 doses/day Acetaminophen 1 g × 4 PO Ketorolac 15 mg × 4 IV on Day 1, then Ibuprofen 800 mg × 4 PO Hydromorphone for rescue analgesia
Primary total knee arthroplasty McDonald et al., 2011 [27]	2 h before surgery: Temazepam 10–20 mg × 1 Dexamethasone 10 mg × 1 Gabapentin 300 mg × 1 Acetaminophen 1 g × 1	Spinal anesthesia with 2.75–3.2 mL 0.5% Bupivacaine. 200 mL intra-articular 0.2% Ropivacaine (at the end of surgery).	Gabapentin 300 mg × 2 Acetaminophen 1 g × 4 Ibuprofen 400 mg × 3 Oxycodone 5–10 mg 2–4 hourly as required Three bolus doses of 40 mL Ropivacaine (0.2%), each via intra-articular catheter at 4 h post-surgery, 2300 h, and 0800 h the following morning. Intra-articular catheter then removed.
Hip hemiarthoplasty for fractured neck of femur Talboys et al., 2015 [28]	Preoperatively, patients are prescribed a dose of acetaminophen of 1 gram (g) PO and tramadol M/R 50–100 mg × 2. A fascia iliaca compartment block (FICB) comprising of 30 mL of levobupivacaine 0.25% is given in the emergency department.	A single shot of spinal bupivacaine (2.5–3.0 mL); no intrathecal opiates are used.IV dexamethasone 8 mg and diclofenac 75 mg. Perioperatively, the surgeon infiltrates the joint with 150–200 mL of ropivicaine 0.2%. A periarticular catheter is then set up to deliver an infusion of the LA: an initial 20 mL bolus followed by an infusion rate of 8 mL/h (with 5 mL bolus every 20 min).	Gabapentin 300 mg twice daily for 5 days Acetaminophen 1 g × 4 Ibuprofen 400 mg × 3 for 1 week When required, tramadol M/R 50–100 mg × 2 Severe breakthrough pain is managed with Oramorph liquid 5–10 mg every 2 hours.
Open abdominal aortic surgery Renghi et al., 2013 [29]	Proparacetamol 2 g × 1 Fentanyl 100 mcg × 1	Fascia of the parietal peritoneum was infiltrated subcutaneously with 20 mL of levobupivacaine (0.5%)	At the end of surgery, subfascial and subcutaneous placement of a double-multiperforated catheter was performed, and an infusion of levobupivacaine, 0.25% at 4 mL/h, was started. Ibuprofen 600 mg × 3 PO Ketorolac 30 mg IV for rescue analgesia
Laparoscopic colorectal surgery Hubner et al., 2015 [20]	None	Fentanyl at discretion of anesthesiologist	Morphine PCA Paracetamol 1 g × 4 PO Metamizole 500 mg × 4 PO

Abbreviations: IV—intravenous; PO—per oral; LA—local anaesthetic; M/R—modified release; PCA—patient controlled analgesia.