Early Recovery after Surgery
The transformative impact of ERAS (Enhanced Recovery After Surgery) for accelerated post-operative healing. Discover how ERAS revolutionizes traditional surgical approaches, leading to faster recovery, reduced complications, and improved patient outcomes. Gain insights into key components of ERAS, such as early mobilization, tailored fluid management, optimized pain control, and nutritional support. Witness real-life examples showcasing the efficacy of ERAS in pediatric and adult surgeries. Join the ERAS movement for a brighter future in surgical care.
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Presentation Transcript
ERAS Early Recovery after Surgery Applying Effectively What we Already Know.
Agenda Traditional Surgery and ERAS Enhanced Recovery Components. Improved Outcomes in Adult Surgery Possibilities in Pediatric Surgery. Summary.
Traditional colorectal surgery. Foley and NG Epidural for 3-4 days. PCA MBP Slow feeding. Lots of narcotics. Fasting. IV fluids as needed LOS 4-6 days
ERAS No tubes or MBP or Fasting TAP or short Epidural Immediate feeding Minimal narcotics. Goal directed fluids (less swelling) Fewer Complications, Shorter LOS
2 Examples CY 4 yr old with UC on TPN, bleeding Albumin was 2 Lap assisted colectomy after 1 week of optimization on ERAS Ate immediately, got swollen , ?? Albumin Recovered after 3-4 days, ate, removed Red Rubber catheter. Home on POD 6
2 Examples DS 15 yr old w 2 yr h/o UC, unable wean steroids Lap colectomy w ERAS DC on POD 2 Lap assisted proctecomy, J pouch, ileostomy DC on POD 3 on ERAS Closure of ileostomy. DC on POD 3 on ERAS
Fluid/ electrolytes/ nutritional status
Prevention of complications
Decrease in nonsurgical complications
What Next? In-patients need to be optimized Outpatient elective surgery is where the impact seems greatest Opportunities exist to expand to other types besides Colorectal Best to do this with a team that s dedicated Team includes nursing, Anesthesia, Surgery
Conclusions Culture change. Applying what we already know effectively Reduce complications >> LOS >> RTS Works in Peds. Come join us with your IBD patients
