ERAS for Patients

Enhanced Recovery After Surgery (ERAS)

ERAS represents an improvement in the way care is delivered to you during your entire surgical journey. As a concept, it is a renewed focus on you, your preparation for and recovery from major surgery.

In practice, it is a set of guidelines that have been developed collaboratively by your anesthesia and surgical teams from the most cutting-edge scientific research. The goal of ERAS is to help you return home faster and have an improved overall surgical experience.

What Is Our Role?

PAA anesthesiologists have been leaders in ERAS at Novant Health facilities since its inception in 2016. We collaborate with key members of your surgical team to create and implement the ERAS pathways, and we’re continually keeping these guidelines updated to reflect the latest research. On a day-to-day basis, our primary role is to ensure that the guidelines are optimized to who you are as an individual. We do this by tailoring our protocols to your medical history, performing specialized nerve blocks, and interpreting data from state-of-the-art monitors. This allows us to optimize variables ranging from the amount of fluid you receive to the settings on the ventilators that breathe for you while you’re asleep, and so much more.

125 +
Participating Surgeons

9 +
Participating Facilities

GET HOME
FASTER
35-60%

Average Reduction in
Length of Stay

LESS PAIN, FEWER NARCOTICS
55%

Average Reduction of
In-Hospital Opioids

REDUCED COMPLICATIONS
20%

Average Reduction of Discharge and Opioids Prescriptions

Current Adult ERAS Pathways:

  • Colorectal
  • Bariatric
  • Prostatectomy
  • Gynecologic Oncology
  • Gynecology
  • Mastectomy/Reconstruction
  • Deep Inferior Epigastric Perforator Autologous Breast Reconstruction
  • Complex Spine
  • Thoracic
  • Cardiothoracic
  • Total Joint Arthroplasty
  • Cesarean Section
  • Whipple
  • Hepatectomy
  • Gastrectomy

What to Expect From Your ERAS Pathway

Before Surgery:

Day Of Surgery:

Pre-Operative

  • On arrival, you will meet the nurse who will prepare you for surgery. After taking a medical history, your RN will place 1 or 2 intravenous catheters (IVs) in your hand or arm and fluids will be started.
  • You will be covered with a special blanket to help keep your body temperature normal.
  • You will be given non-opioid medications that are part of the multimodal pain regimen.  This helps us to stay ahead of any postoperative pain and helps us to reduce or eliminate the need for opioid pain medication during and after surgery.
  • You may have a small patch placed behind your ear as part of postoperative nausea and vomiting prevention. Try not to touch it because if you do touch it and accidentally rub your eyes, it will cause your pupils to dilate.
  • You will meet your anesthesiologist before surgery.  He or she will go over your medical history and explain your anesthesia.  Be sure to ask any questions you may have.

Intra-Operative

  • Evidence-based, best practice recommendations will be used throughout the surgery to ensure individualized management of vital signs, pain control, IV fluid infusions and medication administration.
  • After being placed on monitors and breathing oxygen, you will drift off to sleep with IV medications.
  • Once you're asleep, you will have a breathing device placed to support your breathing while you're asleep.  This breathing device is removed before you wake up, but it may cause a sore throat for a few days after surgery.
  • Depending on the procedure, some patients may receive a nerve block (regional anesthesia) after falling asleep.  These blocks help reduce pain after surgery.

Post-Operative

  • After your surgery is complete, we’ll bring you to the recovery area where a nurse will closely monitor your vital signs as you wake up.
  • Your nurse will ask you about any pain or nausea you feel. He or she will be able to provide medications to treat any discomfort.
  • Once you’re awake, you’ll be able to have something to drink.
  • After you’ve recovered from anesthesia, you’ll be transferred to your hospital room (if you are staying the night) or you’ll be discharged (if you had a same-day surgery planned).

Hospital Room or Home

  • Your pain will continue to be managed in a way that minimizes opioids and maximizes comfort by keeping you on a prescribed schedule of non-opioid pain medications. It’s important to adhere to this schedule in order to stay ahead of postoperative pain. If needed, you may take opioid pain medications, however, many ERAS patients do not need them thanks to this multimodal approach to pain control.
  • You'll be given medications for nausea to take as needed.  If you had a nausea patch placed before surgery, it can remain on for three days.
  • Your post-operative diet will depend on your surgery. It's important that you follow the diet for energy and to promote healing.
  • You'll be expected to walk and move around the day of your surgery and beyond. This prevents blood clots.
  • If at any point you have concerns about the ERAS pathway, you may reach out to us with questions.

See What Our Surgical Colleagues and Patients Are Saying

Frequently Asked Questions

If you have a non-urgent question about ERAS please click here and our ERAS coordinator will be happy to assist you.