Table 1.
ERAS society guideline elements for colonic resections
| Element | Responsible professional |
Involvement patient |
|---|---|---|
| Preadmission | ||
| 1 Cessation of smoking and excessive intake of alcohol | Surgeon, patient | Active |
| 2 Preoperative nutritional screening and, as needed, assessment and nutritional support | Surgeon | Active/Passive |
| 3 Medical optimization of chronic disease | Anaesthetist | Passive |
| Preoperative | ||
| 1 Structured preoperative information and engagement of the patient and relatives or caretakers | Nurse | Passive |
| 2 Preoperative carbohydrate treatment | Nurse | Active/Passive |
| 3 Preoperative prophylaxis against thrombosis | Surgeon | Active/Passive |
| 4 Preoperative prophylaxis against infection | Anaesthetist | Passive |
| 5 Prophylaxis against nausea and vomiting | Anaesthetist | Passive |
| Intraoperative | ||
| 1 Minimal invasive surgical techniques | Surgery | Passive |
| 2 Standardized anesthesia, avoiding long-acting opioids | Anaesthetist | Passive |
| 3 Maintaining fluid balance to avoid over- or under hydration, administer vasopressors to support blood pressure control | Anaesthetist | Passive |
| 4 Epidural anesthesia for open surgery | Anaesthetist | Passive |
| 5 Restrictive use of surgical site drains | Surgeon | Passive |
| 6 Removal of nasogastric tubes before reversal of anesthesia | Anaesthetist | Passive |
| 7 Control of body temperature using warm air flow blankets and warmed intravenous infusions | Anaesthetist | Passive |
| Postoperative | ||
| 1 Early mobilization (day of surgery) | Patient | Active |
| 2 Early intake of oral fluids and solids (offered the day of surgery) | Patient | Active |
| 3 Early removal of urinary catheters and intravenous fluids (morning after surgery) | Nurse | Active/Passive |
| 4 Use of chewing gums and laxatives and peripheral opioid-blocking agents (when using opioids) | Patient | Active |
| 5 Intake of protein and energy-rich nutritional supplements | Patient | Active |
| 6 Multimodal approach to opioid-sparing pain control | Anaesthetist | Passive |
| 7 Multimodal approach to control of nausea and vomiting | Anaesthetist | Passive |
| 8 Prepare for early discharge | Nurse, patient | Active/Passive |
| 9 Audit of outcomes and process in a multi-professional, multidisciplinary team on a regular basis | Whole team | Passive |