Learning About Enhanced Recovery After Surgery (ERAS)

What is enhanced recovery after surgery (ERAS)?

Enhanced recovery after surgery, or ERAS, is a way to help people prepare for surgery. The goal is to help you get ready for surgery and get better sooner. Before your surgery, you:

• Eat well in the days leading up to the surgery.
• Drink lots of clear fluids.
• Learn some basic information about your surgery, such as what will happen and what to expect. Doing this can put your mind at ease.

Your doctor will explain any other tips to help you recover. You may have to avoid some foods. You may also need to empty your colon with a laxative or an enema.

During surgery, you may get different kinds of medicine for pain. This can help you heal sooner and feel less pain later.

Soon after surgery, you will also drink fluids, eat as soon as you can, and try to walk a little. Different types of pain medicine may be used after surgery. This can also reduce the need for strong pain medicines like opioids and reduce side effects like constipation.

These recovery tips may be recommended for many types of surgeries, such as:

• Colorectal surgery.
• Surgery on the veins, arteries, heart, lungs, or other organs.
• Surgery to remove a growth (tumor).
• Surgery on bones and joints.

Knowing what to expect before, during, and after surgery can help ease your concerns. It can also help you take an active role in your recovery. Ask the doctor any questions you may have.

How do you prepare for surgery?

Your doctor will give you instructions to follow before your surgery. They may ask you to:

• Eat healthy foods in the weeks leading up to your surgery. This includes a wide range of foods like grains, vegetables, fruits, and protein, such as lean meat and beans. Your doctor will tell you how long before surgery to stop eating.
• Try to get more exercise in the weeks before your surgery. Even a little walking can help. The better shape you are in, the sooner you are likely to recover.
• Drink plenty of liquids. Your doctor may prescribe that you have a special sugary drink 2 to 3 hours before your surgery. This will give your body added energy. Your doctor will tell you when you should stop drinking liquids.
• Stop taking any medicines.
• Stop or cut down on your use of alcohol.
• Don’t smoke, vape, or use other tobacco or nicotine products. These things slow healing and recovery. Stop smoking for at least a month before surgery. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
• Reduce your stress. Understand exactly what surgery is planned, along with the risks, benefits, and other options. Let your doctor know how you are feeling so they can tell you what to expect and answer your questions or concerns.
• Have a plan with your doctor on how to manage pain after surgery.

What can you expect during your surgery?

You will get medicine so that you relax and don't feel pain during your surgery. The surgical team will closely watch your fluid levels during the surgery to keep you well hydrated.

What can you expect after surgery?

You will drink water and eat healthy foods as soon as you can after surgery. Your care team will help you move as much as you can, such as sitting up in a chair while you eat. You'll get up and walk as soon as you can. The more you can move, or at least sit up in a chair, the better.

You may be given medicines during surgery to block the pain from the affected area of your body. You may also be given medicine like acetaminophen or ibuprofen. If strong pain medicines like opioids are used, your doctor will give you the lowest dose for the shortest possible time. Opioids can make your recovery harder. And they can be less safe than other medicines.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and contact your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.