Table 1.
Operative Phase | Elements Already in Place |
What We Gave Up | Changes Induced by Our ERP |
---|---|---|---|
Pre | Preoperative assessment General patient information including smoking cessation |
Stop food and drinks at midnight the day before surgery | Patient empowerment with dedicated information leaflet Carbohydrates intake |
Per | Intraoperative warming Prophylactic antibiotics Goal directed fluid therapy Protective ventilation Targeted postoperative nausea prevention Regional anesthesia catheter |
No use of non-steroid anti-inflammatory drugs use No strategy of chest tube management |
Opiate analgesia avoidance strategy with non-steroid anti-inflammatory drugs use Single chest tube |
Post | Venous thromboembolism prophylaxis Targeted postoperative nausea prevention Opioids for breakthrough pain Mobilization within 24 h |
Pain evaluation at rest Continuous regional anesthesia Opioids personalized controlled anesthesia Maintenance of intravenous analgesics and fluids Feeding at POD 1 No consensus on chest tube management |
Pain evaluation at rest and mobilization Personalized controlled regional anesthesia non-steroid anti-inflammatory drugs use Early infusion withdrawal Early feeding and mobilization at day 0 Consensus on chest tube management |