Enhanced recovery after surgery (ERAS) for the anaesthesiologist

Abstract

Enhanced recovery after surgery (ERAS) protocol consists of entire spectrum of pre, intra and post-operative designed to enhance patient outcomes. Since its first introduction for major abdominal surgery in the 1990’s, ERAS protocols have been successfully used extensively in many countries in several major surgical procedures. When effectively implemented, ERAS resulted in reduction in hospitalization, improvement in satisfaction of the patients, and reduction in complication rate without an increase in re-admissions. Implementation of ERAS in India has also positively affected the patient experience and led to efficient utilization of valuable hospital resources. Many of the ERAS components are linked to the anaesthesia team. Anaesthesiologists help in preparing anaesthesia, they also ascertain the fasting regime in preoperative period, assess premedication, and introduce prophylaxis for post-operative nausea and vomiting (PONV). Intraoperatively, they introduce low sodium fluid therapy, help in preventing hypothermia, and utilize short acting drugs. They also help in important decision making during postoperative analgesia. An anaesthesiologist role is foremost important in the implementation of ERAS protocol. The article aims to discuss the various components of ERAS and the role of anaesthesiologist in implementing them.