Hospital ERAS programs help patients recover faster after surgery.
Many hospitals use a post-op recovery process called Enhanced Recovery After Surgery (ERAS). With these programs, patients experience faster recovery, shortened hospital stay and significantly fewer complications.
For example, a study evaluated the outcomes of cancer patients who had colorectal surgery and found that for patients with ≥70% adherence to ERAS interventions, the risk of death from cancer within 5 years was lowered by 42%.
Additionally, a meta-analysis of studies regarding the impact of ERAS programs on patients undergoing elective colorectal surgery found that ERAS programs:
- Reduced overall morbidity rates.
- Shortened lengths of hospital stays.
- Significantly reduced nonsurgical complications.
And studies on gynecologic and gynecologic oncology surgeries found the following benefits:
- Shorter hospital stays.
- Decreased postoperative pain and need for analgesia.
- Faster return of bowel function.
- Decreased complication rates.
- Decreased readmission rates.
- Increased patient satisfaction.
What are the key elements to an ERAS program?
Although there are many elements to ERAS programs, here are a few:
Encourage more food and fluids.
The ERAS guidelines encourage stopping solid food 6 hours and clear fluids 2 hours before surgery. This approach challenges historical practices such as requiring nothing by mouth from midnight before the morning of surgery. Interestingly, this updated approach is consistent with recent guidelines from the American, Canadian and European societies of anesthesiology.
This relaxation of food and liquid limitations gives patients energy through nutrition which helps the body recover faster after surgery.
Control pain with non-narcotics.
Instead of providing narcotics after surgery which can cause dizziness and slow bowel function, many ERAS protocols now routinely advocate for a non-narcotic approach with regular scheduled doses of NSAIDs and acetaminophen.
Get out of bed.
For information on the many elements of ERAS programs, visit the ERAS Society website.
Steps you can take to recover faster after surgery.
Certainly, it’s great if you can use a hospital with programs in place to help you recover faster after surgery. Ask your surgeon (or prospective surgeon) if his/her hospital follows ERAS procedures. If the answer is “no”, ask your surgeon what steps the hospital takes to aid recovery.
Whether or not your hospital follows ERAS procedures, the following 14 steps will help you recover faster after surgery:
1. Follow your doctor’s orders.
Certainly, following your doctor’s orders is an important part of recovering. And that means following all recommendations, not just the ones that are easy or seem logical to you. If you think a particular instruction doesn’t make sense, don’t just disregard it. Instead, have a conversation with your doctor.
2. Don’t overdo it.
Importantly, don’t go back to work too early! Before your procedure, ask your doctor how much time you will need before returning to work. Then make any needed plans to stay home as long as he/she recommends. Lastly, don’t drive before your doctor’s recommended time period.
3. Don’t stay in bed all day.
Before you leave the hospital, ask your doctor how often you should get out of bed, for how long, and what activities are safe. As soon as your doctor recommends, get out of bed and move around, even if you feel exhausted.
Movement is critical because prolonged bed rest can lead to potentially dangerous blood clots, life-threatening pulmonary embolisms, and pressure ulcers (bed sores). Additionally, too much time in bed can weaken your muscles, making it hard to get back to your old life.
4. Take your medications as prescribed.
For more information, read 10 Tips for Avoiding Medication Issues After a Hospital Stay.
5. Stay ahead of the pain.
Keeping your pain under control is very important so don’t be afraid of pain medication if you need it. In fact, if pain hampers your ability to sleep and move, it can take you longer to recover. For instance, if pain prevents you from coughing, you could develop pneumonia.
And if pain makes it impossible to get out of bed, your risk of pneumonia and dangerous blood clots increases. Waiting until your pain is severe can make it hard to reach a tolerable pain level.
Instead, control your pain by taking pain medication as prescribed. However, pain medications can be addictive, so talk to your doctor about their safe use.
And drink plenty of fluids when taking pain medications since they can cause dehydration and constipation.
6. Make and attend all recommended follow-up appointments.
For starters, your doctor may find changes or issues that you cannot see or feel. And your doctor may want to do blood work, and/or look for signs of infection. Also, you may need medication adjustments.
And of course, your doctor will want to see if your procedure successfully treated your medical condition. Consider making these appointments before your procedure so you have one less thing to worry about when you get home.
7. Reduce your risk of post-op infections.
Infections, which can start in your incision, in your blood, or in the area surrounding your incision, can be hard to treat, and can slow your recovery time.
Additionally, you can develop an infection that seems unrelated to your procedure, such as a urinary tract infection.
To reduce your risk of infections after surgery, follow these recommendations:
Follow the care instructions you’re given.- Keep your wound and the dressings clean and dry. Ask your surgeon the best way to clean and dress your incision area and carefully follow the recommendations.
- Wash your hands before cleaning the surgical site or changing the dressings.
- Follow all medication instructions you’re given, including finishing your entire antibiotics prescription.
- Maintain a healthy diet.
- Avoid using tobacco. Importantly, smoking reduces blood flow, which slows healing, increasing your risk of infections.
- Don’t put anything on the surgical site, like ointment, unless your doctor tells you to.
Additionally, everything you touch in public has the potential to spread an infection, so use an antibacterial hand cleanser frequently when you’re away from home.
8. Properly care for your incision.
As discussed, always wash your hands before touching your incision. But how should you keep it clean? Ask your doctor what steps to take and follow his/her instructions. Resist the temptation to scrub your incision with gusto.
9. Regularly inspect your incision for signs of infection.
Ask your doctor how to recognize signs of infection, and if physically possible, take a careful look at your incision (with clean hands) a few times a day. Importantly, notify your doctor as soon as you detect a potential infection.
10. Stay on top of your nutrition.
Although pain, nausea and/or exhaustion can make it tempting to avoid eating and drinking, proper nutrition can help you recover faster from your surgery. If you are too nauseous to drink or eat, ask your doctor for suggestions.
11. Keep up with physical therapy.
If your doctor prescribes physical therapy, make every effort possible to go to the appointments and to do your recommended exercises at home.
12. Continue with prescribed breathing exercises.
For certain procedures, your doctor may give you breathing exercises to help your lungs recover from anesthesia by expanding your lungs and removing mucous. Don’t stop these breathing exercises prematurely.
13. Cough and sneeze carefully!
What should you do? Apply pressure to your incision area, with your hands or a pillow, when coughing or sneezing (and pooping). However, it’s important to realize that coughing can help prevent pneumonia, so don’t suppress a cough. If you’re concerned, talk to your doctor.
14. Know when you need medical help.
Before you leave the hospital, ask your doctor what symptoms would warrant a trip to the emergency room. However, if you are concerned at any time, call your doctor, or go to an ER.
While recovering from surgery, contact your care team if you experience unexpected issues or you develop complications, including the following recommendations from UVA Health:
- Signs of infection, like fever and chills.
- Redness, swelling, pain, bleeding, or any discharge from the surgical site.
- Nausea or vomiting that doesn’t improve.
- Pain that doesn’t improve with medication.
- Cough, chest pain, or difficulty breathing.
- Coughing up yellow, green, or bloody mucus.
- Pain or swelling in your feet or legs.
Importantly, call 911 if you suddenly have chest pain and/or a hard time breathing.
Learn more…
For more information on reducing the risk of surgical complications and harm, read these blog posts:
- Questions to Ask Before Surgery.
- Questions Seniors Should Ask Before Surgery.
- You Can Improve Your Surgical Outcome.
- Surgical Dangers – What You Need to Know.
- What is the Best Time of Day for Medical Care?
- How Safe are Surgery Centers?
NOTE: I updated this post on 2-6-26.
