Written by Dr.Medhat Shalabi, Consultant – Anaesthesiology
The enhanced recovery programs aim to improve patient care and decrease the length of hospital stay following surgical operations. We are trying to make the journey of having an operation as natural as possible also improve the patient experience and satisfaction.
This means that patients might achieve the gold standards of being fit to be discharged from hospital a lot quicker than before. The benefit of early discharge after surgery is minimal disruption to the patient’s family life and without adding any risks for the patient because the safety of our patients is of utmost importance to us.
Before the operation:
If the patient smoke he/she should try to stop or reduce smoking in the weeks before surgery. If the patient continues to smoke he/she should try not to have any cigarettes the night before or the morning of surgery, as this will improve your breathing after surgery. It will also help the healing process and reduce the risk of a chest infection.
For everyone, it is a good idea to go for daily walks and practice taking deep breaths. Deep breathing helps the patients to recover more quickly from the effects of the anesthetic and the operation.
Eating and drinking before the operation
In Enhanced Recovery after Surgery the very prolonged fasting before the operation is no longer present. The new international guidelines allow patients to eat and drink as follow:
- 8 hours before operation for normal meals
- 6 hours for completely fat free light meals
- 3 hours for clear fluids that patients can see through and must not be fizzy and no pulps neither particle within.
- In AZHD we advise our patients to drink a specially formulated fruit flavored carbohydrate drink 3 hours before the operation, this helps them a great deal.
During the operation:
The new anesthesia care of the patient has lots to offer than just being safe; safety during anesthesia is a basic and essential standard of care. Modern anesthetic care helps the patient to recover and come back to normal a lot quicker than before. This is achieved by many ways;
1- Very effective control of the pain, by using many different drugs and state of the art ways to completely relief the pain and at the same time use the lowest possible dose of Morphine like drugs.
2- Keeping the patient warm during surgery
3- Keeping the patient well hydrated during surgery but avoiding giving more or less fluid than needed.
4- Trying to avoid Post-operative sickness or vomiting, and aggressively treating these very unpleasant symptoms if they happen.
5- Using the best and the most modern anesthetics and those which have no residual effect on the body and with the shortest duration of effect.
6- Giving prophylactic doses of antibiotics before the operation as per the International guidelines if needed.
7- Giving prophylactic injections against the formation of blood clots if indicated by the type of surgery or the patient condition itself.
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