Enhanced recovery protocols

Abstract

Traditional empirically derived postoperative measures failed to produce the intended benefits for patients after major abdominal surgery and may in fact have been doing harm. Routine nasogastric tube decompression, fasting until first stool, long periods of bed rest, and excessive doses of narcotic analgesics have largely been replaced with immediate diet advance, early ambulation, and nonnarcotic analgesia. These enhanced recovery protocols result in shorter hospital stays, improved outcomes, and happier patients. Although most studies have been performed in adults, there is increasing evidence that children also benefit when treated using these progressive protocols.