Table 2.
Preoperative Phase Preoperative risk assessment for the special surgery Information to all the relative nurses, doctors and patients Fluid optimization |
Alcohol/smoking abstinence No bowel preparation Modern fasting guidelines:oral glucose fluid 2 h before surgery |
Intraoperative Phase Fluid optimisation (avoid hypovolaemia and crystalloid excess) :2000ml-2500ml/day in the day of surgery Regional anaesthesia:transabdominal pain block before the end of general anaesthesia Type of incision:horizontal Short-acting opioids |
Postoperative Phase Multimodal analgesia:intravenous, by mouth. Anti-emetic and anti-ileus prophylaxis Revise use of drains, tubes, catheters, monitoring, etc. Thromboembolic prophylaxis Early oral nutrition and ambulation:drink water 2 h after surgery;fluid and ambulation in the day one after surgery Daily care maps, well-defined discharge criteria Rehabilitation plan |