Enhanced Recovery After Surgery

Mr. Novák (55 years old, smoker) is admitted to the surgical ward. He has been diagnosed with colorectal adenocarcinoma in the region of colon descendens and indicated for resection. The patient has been selected for the programme ERAS (enhanced recovery after surgery). The ERAS protocol focuses on prehabilitation of the patient, preoperative counseling about the surgical and anaesthetic procedures, possible complications and early postoperative care. It is generally accepted that preoperative medical optimization is necessary before surgery, so Mr. Novák had been advised to stop smoking at least 4 weeks before surgery and reduce alcohol consumption. How will his preoperative preparation look like?

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Preoperative bowel preparation, administration of LMWH, intravenous antibiotics, preoperative fasting: solids up to 6 hours, 400 mL carbohydrate treatment up to 2-3 hours or clear fluids up to 2 hours before the procedure.

Preoperative bowel preparation, preoperative fasting: solids and fluids until midnight before surgery.

Administration of LMWH, intravenous antibiotics, preoperative fasting: solids up to 6 hours, 400 mL carbohydrate treatment up to 2-3 hours or clear fluids up to 2 hours before the procedure.

Administration of LMWH, intravenous antibiotics, preoperative fasting: solids and fluids until midnight before surgery.

years

man

16 /min

68 /min

124/81 (95) mmHg

EKG

rythm: sinus
action: regular
frequency: 68 bpm