![ENHANCED RECOVERY
AFTER SURGERY [ERAS]
Dr. Gunjan S Desai
Consultant Gastrointestinal and HPB Surgeon](https://image.slidesharecdn.com/fast-track-surgery-edusurg-clinics-231107111542-61cf3285/85/fast-track-surgery-pptx-2-320.jpg)
![ENHANCED RECOVERY
AFTER SURGERY [ERAS]
Dr.Gunjan S Desai
Consultant Gastrointestinal and HPB Surgeon](https://image.slidesharecdn.com/fast-track-surgery-edusurg-clinics-231107111542-61cf3285/85/fast-track-surgery-pptx-3-320.jpg)
![*
.
^
^
!
i
^
^
^
ENHANCED RECOVERY
AFTER SURGERY [ERAS]
Dr.Gunjan S Desai
Consultant Gastrointestinal and HPB Surgeon](https://image.slidesharecdn.com/fast-track-surgery-edusurg-clinics-231107111542-61cf3285/85/fast-track-surgery-pptx-4-320.jpg)
fast-track-surgery-.pptx
- 2. ENHANCED RECOVERY AFTER SURGERY [ERAS] Dr. Gunjan S Desai Consultant Gastrointestinal and HPB Surgeon
- 3. ENHANCED RECOVERY AFTER SURGERY [ERAS] Dr.Gunjan S Desai Consultant Gastrointestinal and HPB Surgeon
- 4. * . ^ ^ ! i ^ ^ ^ ENHANCED RECOVERY AFTER SURGERY [ERAS] Dr.Gunjan S Desai Consultant Gastrointestinal and HPB Surgeon
- 5. TOPICS CONCEPT Henrlk Kehlet Firat ERAS guidelines ERAS soclet
- 6. CONCEPT Henrlk Kehlet Firat ERAS guldelinea ERAS soclet PRE-OP Counseling Prehabilitatlon ih d ate Loading nt
- 7. CONCEPT Henrlk Kehlet First ERAS guidelines ERAS o i t PRE-OP Counseling Prehabilitation Carbohydrate Loading Antibiotics INTRA-OP Incision Epidural Drains Catheters Fluld management POST-OP Mobilization Pain rellef Draln removal Oral intake
- 15. INTRODUCTION HYPOTHESIS - HENRIK KEHLET Surgery Pain Stress response Nausea, Vomiting Ileus Fatigue Hypoxemia, sleep disturbance Immobilization Semi-starvation Drains/ tubes/ restriction Delayed Recovery
- 16. INTRODUCTION HYPOTHESIS - HENRIK KEHLET Surgery Pain Stress response Nausea, Vomiting Ileus Fatigue Hypoxemia, sleep disturbance Immobilization Semi-starvation Drains/ tubes/ restriction Delayed Recovery
- 17. INTRODUCTION HYPOTHESIS - HENRIK KEHLET Surgery Pain Stress response Nausea, Vomiting Ileus Fatigue Hypoxemia, sleep disturbance Immobilization Semi-starvation Drains/ tubes/ restriction Delayed Recovery
- 18. INTRODUCTION HYPOTHESIS - HENRIK KEHLET Surgery Pain Stress response Nausea, Vomiting Ileus Fatigue Hypoxemia, sleep disturbance Immobilization Semi-starvation Drains/ tubes/ restriction Delayed Recovery
- 19. INTRODUCTION HYPOTHESIS - HENRIK KEHLET Surgery Pain Stress response Nausea, Vomiting Ileus Fatigue Hypoxemia, sleep disturbance Immobilization Semi-starvation Drains/ tubes/ restriction Delayed Recovery <
- 20. INTRODUCTION HYPOTHESIS - HENRIK KEHLET Surgery Pain Stress response Nausea, Vomiting Ileus Fatigue Hypoxemia, sleep disturbance Immobilization Semi-starvation Drains/ tubes/ restriction Delayed Recovery <
- 21. INTRODUCTION HYPOTHESIS - HENRIK KEHLET Surgery Pain Stress response Nausea, Vomiting Ileus Fatigue Hypoxemia, sleep disturbance Immobilization Semi-starvation Drains/ tubes/ restriction Delayed Recovery
- 22. INTRODUCTION HYPOTHESIS - HENRIK KEHLET Surgery Pain Stress response Nausea, Vomiting Ileus Fatigue Hypoxemia, sleep disturbance Immobilization Semi-starvation Drains/ tubes/ restriction Delayed Recovery
- 23. Shorter length o WHY ERAS KEY OUTCOMES
- 24. Shorter length of stay ' Reduced post-op"" complications t Reduced costc standardization WHY ERAS KEY OUTCOMES
- 25. KEY COMPONENTS
- 27. KEY COMPONENTS Pre-operative Intra-operative Post-operative E1Lk '贈k3促MB
- 28. KEY COMPONENTS Pre-operative Intra-operative Post-operative
- 29. KEY COMPONENTS Pre-operative Intra-operative Post-operative
- 30. KEY COMPONENTS Pre-operative Intra-operative Post-operative
- 40. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Post-operative
- 41. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Post-operative
- 42. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Post-operative
- 43. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Post-operative
- 44. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Post-operative
- 45. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Post-operative
- 46. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Incision/ MIS Post-operative
- 47. KEY COMPONENTS Selective Bowel Prep W Pre-operative Coun6eling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Incision/ MIS Normothermia Post-operative
- 48. KEY COMPONENTS Selective Bowel Prep W Pre-operative Coun6eling Carbohydrate Loading Antibiotic prophylaxis e Thrombo prophylaxis Intra-operative Incision/ MIS Normothermia Post-operative
- 49. KEY COMPONENTS Selective Bowel Prep W Pre-operative Coun6eling Carbohydrate Loading e Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Incision/ MIS Normothermia Fluid management Post-operative
- 50. KEY COMPONENTS Selective Bowel Prep W Pre-operative Coun6eling Carbohydrate Loading e Antibiotic prophylaxis Thrombo prophylaxis - Intra-operative Incision/ MIS Normothermia Fluid management Post-operative
- 51. KEY COMPONENTS Selective Bowel Prep W Pre-operative Coun6eling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis - Intra-operative Incision/ MIS Normothermia Fluid management Post-operative
- 52. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Incision/ MIS Normothermia Fluid management Analgesia PONV prophylaxis Post-operative
- 53. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Incision/ MIS Normothermia Fluid management Analgesia PONV prophylaxis Post-operative
- 54. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Incision/ MIS Normothermia Fluid management Analgesia PONV prophylaxis Post-operative
- 55. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Incision/ MIS Normothermia Fluid management Analgesia PONV prophylaxis Post-operative
- 56. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Incision/ MIS Normothermia Fluid management Analgesia PONV prophylaxis Post-operative
- 57. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Incision/ MIS Normothermia Fluid management Analgesia PONV prophylaxis Post-operative
- 58. KEY COMPONENTS Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Selective Bowel Prep Intra-operative Incision/ MIS Normothermia Fluid management Analgesia PONV prophylaxis Post-operative Early Mobilization Nil drains
- 59. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Incision/ MIS Normothermia Fluid management Analgesia PONV prophylaxis Post-operative Early Mobilization NG/ drains early removal
- 60. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Incision/ MIS Normothermia Fluid management Analgesia PONV prophylaxis Post-operative Early Mobilization NG/ drains early removal
- 61. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Incision/ MIS Normothermia Fluid management Analgesia PONV prophylaxis Post-operative Early Mobilization NG/ drains early removal Avoid Opiates/ NSAIDs
- 62. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Incision/ MIS Normothermia Fluid management Analgesia PONV prophylaxis Post-operative Early Mobilization NG/ drains early removal Avoid Opiates/ NSAIDs
- 63. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Incision/ MIS Normothermia Fluid management Analgesia PONV prophylaxis Post-operative Early Mobilization NG/ drains early removal Avoid Opiates/ NSAIDs
- 64. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Incision/ MIS Normothermia Fluid management Analgesia PONV prophylaxis Post-operative Early Mobilization NG/ drains early removal Avoid Opiates/ NSAIDs Early diet
- 65. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Incision/ MIS Normothermia Fluid management Analgesia PONV prophylaxis Post-operative Early Mobilization NG/ drains early removal Avoid Opiates/ NSAIDs Early diet
- 66. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Incision/ MIS Normothermia Fluid management Analgesia PONV prophylaxis Post-operative Early Mobilization NG/ drains early removal Avoid Opiates/ NSAIDs Early diet
- 67. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Incision/ MIS Normothermia Fluid management Analgesia PONV prophylaxis Post-operative Early Mobilization NG/ drains early removal Avoid Opiates/ NSAIDs Early diet
- 68. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Incision/ MIS Normothermia Fluid management Analgesia PONV prophylaxis Post-operative Early Mobilization NG/ drains early removal Avoid Opiates/ NSAIDs Early diet
- 69. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Incision/ MIS Normothermia Fluid management Analgesia PONV prophylaxis Post-operative Early Mobilization NG/ drains early removal Avoid Opiates/ NSAIDs Early diet
- 70. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Incision/ MIS Normothermia Fluid management Analgesia PONV prophylaxis Post-operative Early Mobilization NG/ drains early removal Avoid Opiates/ NSAIDs Early diet
- 71. KEY COMPONENTS Selective Bowel Prep Pre-operative Counseling Carbohydrate Loading Antibiotic prophylaxis Thrombo prophylaxis Intra-operative Incision/ MIS Normothermia Fluid management Analgesia PONV prophylaxis Post-operative Early Mobilization NG/ drains early removal Avoid Opiates/ NSAIDs Early diet
- 72. NOT TO MISS
- 73. NOT TO MISS AUDIT Publish data and outcomes Share new findings Review, Re-assess Implement EDUiUR
- 74. NOT TO MISS AUDIT Publish data and outcomes Share new findings Review, Re-assess Implement E D U S U R G
- 75. NOT TO MISS AUDIT Publish data and outcomes Share new findings Review, Re-assess Implement E D U S U R G
- 76. NOT TO MISS AUDIT Publish data and outcomes Share new findings Review, Re-assess Implement
- 77. NOT TO MISS AUDIT Publish data and outcomes Share new findings Review, Re-assess Implement
- 78. To Summarize CONCEPT Henrlk Kehlet Flrat ERAS guidelines ERAS socle PRE-OP Counseling Prehabllltat)on Carbohydrate Loading AntIbIotICB INTRA-OP incision Epidural Drains CathBt6FB Fluid mana ment POST-OP Mob1IIzatIon Pain reI1ef Dra)n removal Oral Intake AUDIT Improve Implement Publleh
- 79. To Summariza CONCEPT Henrlk Kehlet Flrat ERAC guidelines ERAS aocle PRE-OP Counseling Prehabllltat)on Carbohydrate Loading AntIbIot1CB INTRA-OP incision Epidural Drains Cath6t6FB Id mona ement POST-OP Mobilization Pain reI1ef Dra)nremoval Oral Intake AUDIT Improve Implement Publish
- 80. To Summariza CONCEPT Henrlk Kehlet Flrat ERAC guidelines ERAS aocle PRE-OP Counseling Prehabllltat)on Carbohydrate Loading AntIbIot1CB INTRA-OP incision Epidural Drains Cath6t6FB Id mona ement POST-OP Mobilization Pain reI1ef Dra)nremoval Oral Intake AUDIT Improve Implement Publish
- 81. To Summariza CONCEPT Henrlk Kehlet Flrat ERAC guidelines ERAS aocle PRE-OP Counseling Prehabllltat)on Carbohydrate Loading AntIbIot1CB INTRA-OP incision Epidural Drains Cath6t6FB Id mona ement POST-OP Mobilization Pain reI1ef Dra)nremoval Oral Intake AUDIT Improve Implement Publish
- 82. To Summarize Dralns Catheters CONCEPT Henrlk Kehlet Flrat ERAS guidelines ERAS aocie PRE6P Counseling Prehablfltaton Carbohydrate Loading Antlblotlcs INTRAOP incision Eplduzal POST-OP Moblllzatlon Pain relief AUDIT improve Publlah
- 83. To Summarize Dralns Catheters CONCEPT Menrlk Kehlet First ERAS guidelines ERAS socie PRE6P Counseling Prehablfltaton Carbohydrate Loading Antlblotlcs INTRAOP incision Epidural POST-OP Moblllzatlon Pain relief AUDIT Improve Publlah
- 84. To Summarize CONCEPT Henrlk Kehlet Flrat ERAS guidelines ERAS aocie PRE6P Counseling Prehablfltaton Carbohydrate Loading Antlblotlcs INTRAOP incision Eplduzal Dralns Catheters POST-OP Moblllzatlon Pain relief AUDIT improve Publlah
- 85. 10 Summarize CONCEPT Henrik Kehlet First ERAS guidelines ERAS society PRE-OP Counseling Prehabilitatlon Carbohydrate Loading Antibiotics INTRA-OP incision Epidural Drains Catheters F uldmanagement POST-OP Mobilization Pain relief Drain removal Oral intake AUDIT Improve Implement Publish
- 86. 10 Summarize CONCEPT Henrik Kehlet First ERAS guidelines ERAS society PRE-OP Counseling Prehabilitatlon Carbohydrate Loading Antibiotics INTRA-OP incision Epidural Drains Catheters QF-juld management POST-OP Mobilization Pain relief Drain removal Oral intake AUDIT Improve Implement Publish
- 87. 10 Summarize CONCEPT Henrik Kehlet First ERAS guidelines ERAS society PRE-OP Counseling Prehabilitatlon Carbohydrate Loading Antibiotics INTRA-OP incision Epidural Drains Catheters F uldmanagement POST-OP Mobilization Pain relief Drain removal Oral intake AUDIT Improve Implement Publish