Preoperative | Intraoperative | Postoperative |
---|---|---|
Patient/family education | Opioid-sparing, multimodal analgesia | Early nutrition |
Medical optimization | Euvolaemia* | Early mobilization (out of bed) |
Limiting fasting, made nil by mouth 6 h before operation | Normothermia | Minimize intravenous fluids, heplock fluids at 12 h |
Carbohydrate-rich beverage (ClearFast®) given up to 2 h before operation | Normoglycaemia | Management of nausea and vomiting |
Regional block versus epidural placement | Minimize tubes and drains | Minimize opioids |
As measured by adherence to institutional protocol for perioperative fluid administration, including but not restricted to limiting fluids in the preoperative setting, zero fluid balance or intraoperative oesophageal Doppler monitoring, and decreasing postoperative intravenous fluid administration to 75 ml/h for 6 h. ClearFast® (ClearFast, Atlanta, Georgia, USA).