Comparison of enhanced recovery after surgery (ERAS) protocol vs. standard recovery protocol
| ERAS protocol in trauma | Standard recovery protocol in trauma | |
| Preoperative care | ||
| Counseling | Explained in brief while taking consent | Not done |
| Bowel preparation | Not possible | Not possible |
| Carbohydrate loading | Not possible | Not possible |
| NG tube and urinary catheter | Placed always | Placed always |
| Preoperative antibiotics | Inj. Augmentin 1.2 g intravenously and inj. metronidazole 500 mg three times per day | Inj. Augmentin 1.2 g intravenously and inj. metronidazole 500 mg three times per day |
| Intraoperative care | ||
| Goal-based fluid therapy | Not done | Not done |
| Intraoperative warming | Done with warming device always | At the discretion of the team |
| Drain placement | At the discretion of surgeon | At the discretion of the team |
| Epidural analgesia | Placed if there are no contraindications | At the discretion of the team |
| Postoperative care | ||
| Removal of tubes | Remove NG, urinary catheter and drain at 24 hours | Removed at the discretion of the surgeon |
| Initiation of liquid diet | At 24 hours after operation | At the discretion of the surgeon |
| Initiation of solid diet | At 24 hours after initiation of liquid diet, if tolerated the liquid | At the discretion of the surgeon |
| Postoperative pain relief | Paracetamol 1 g intravenously four times per day, inj. diclofenac 50 mg intravenously three times per day, epidural if inserted, morphine as rescue analgesia. Converted to oral medications once solid diet is initiated | At the discretion of the surgeon |
| Thromboprophylaxis | Mechanical sequential compression device, inj. Clexane 0.1 mg per kg once daily if there are no contraindications | At the discretion of the surgeon |
| Ulcer prophylaxis | Inj. pantoprazole 40 mg intravenously once daily converted to oral once solid diet is initiated | At the discretion of the surgeon |
| Postoperative antibiotics | Inj. Augmentin 1.2 g intravenously two times per day and inj. metronidazole 500 mg intravenously three times per day Antibiotics were given for 5 days and then converted to oral if discharged before 5 days | At the discretion of the surgeon |
| Rehabilitation | Physiotherapy-assisted walking, chest physiotherapy and incentive spirometry started at 24 hours after operation | At the discretion of the surgeon |
| Follow-up | In outpatient department (OPD) at 7 days after discharge and at 30 days (OPD or telephonic) | In OPD at 7 days after operation |
NG, nasogastric.