Table 1.

Comprehensive list of preoperative, intraoperative and postoperative ERAS protocol items targeted by the care pathway, customised for paediatric urology patients. The definitions for these items were arrived at through multidisciplinary consensus of the study group

Preoperative	Intraoperative	Postoperative
Counsel about ERAS	Regional anaesthesia (catheter-based block)	Nausea/vomiting prevention
Clear-liquid carbohydrate load (10 mL/kg up to 350 mL)	Avoiding excess drains (intraperitoneal or subcutaneous)	Early feeding (clears POD 0, regular POD 1)
Avoid prolonged fasting (eat regular diet and avoid prolonged clears-only diet day prior to surgery)	Euvolaemia (4–7 mL/kg/hour crystalloid)	Early mobilisation (out-of-bed POD 1)
No bowel preparation (continue bowel regimen if on one)	Normothermia (36°C–38°C during skin-to-skin time)	Adjunctive pain medication (acetaminophen and NSAID)
Antibiotic prophylaxis per American Urological Association guidelines	Minimising opioids (<0.15 mg/kg intravenous morphine equivalents)	Early stoppage of intravenous fluids (either discontinue or lower rate to keep vein open (TKO) by POD 2)
DVT prophylaxis (age ≥14 or risk factors)	Minimally invasive assistance (at surgeon discretion)	Early removal of extra drains/catheters (non-urinary drain removal by POD 4)
	No nasogastric tube on leaving OR	Minimising opioids (<0.30 mg/kg/day intravenous morphine equivalents)

DVT, deep vein thrombosis; ERAS, enhanced recovery after surgery; NSAID, non-steroidal anti-inflammatory drug; OR, operating room; POD, postoperative day.