A review in Canadian Medical Association Journal (CMAJ) has challenged historical surgical practices that are not based on research and outlined a multidisciplinary approach known as ‘Enhanced Recovery after Surgery’ (ERAS) that would help a patient recover quickly after surgery.
The article was published in the Canadian Medical Association Journal. Enhanced recovery after surgery is an evidence-based treatment program created to improve patient outcomes with faster recovery. It takes a holistic approach by involving family doctors, nurses, surgeons, anesthesiologists, nutritionists and other health care professionals before surgery right through recovery, with the goal of helping patients get back to normal functioning as soon as possible.
“ERAS involves changing the way we, as a medical community, think about preoperative, intraoperative and postoperative care to improve all surgical outcomes,” said lead author Dr Alon Altman. It has been shown to promote patient movement after surgery, reduce complications and reduce hospital length of stay as well as costs, and is currently being used in some Canadian hospitals and others around the world, including in the United States and the United Kingdom.
Enhanced recovery after surgery can be broken down into three stages: preoperative, intraoperative (during surgery) and postoperative.
It involves changes such as modifying diet before surgery, stopping certain medications, changing some procedures during surgery, getting patients moving within 24 hours after surgery and more.
“This approach should be used for all surgical patients, as the intent is to lessen stress on the patient and maintain normal functioning,” said Dr Altman.
“Despite the challenges of implementing ERAS, there are clear advantages for patients and the health system, such as a healthier recovery using fewer resources,” said co-author Dr Gregg Nelson
“A team approach, from involving family physicians before patients undergo surgery to surgeons and post-recovery staff in a hospital, is a key part of successful implementation,” added Dr Nelson.