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.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Suggested Reading
Bauer VP. The evidence against prophylactic nasogastric intubation and oral restriction. Clin Colon Rectal Surg. 2013;26(3):182–5.
Delaney CP. Clinical perspective on postoperative ileus and the effect of opiates. Neurogastroenterol Motil. 2004;16 Suppl 2:61–6.
Ford AC, Brenner DM, Schoenfeld PS. Efficacy of pharmacological therapies for the treatment of opioid-induced constipation: systematic review and meta-analysis. Am J Gastroenterol. 2013;108(10):1566–74.
Kehlet H, Mogensen T. Hospital stay of 2 days after open sigmoidectomy with a multimodal rehabilitation programme. Br J Surg. 1999;86(2):227–30.
Kehlet H, Wilmore DW. Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg. 2008;248(2):189–98.
Ljungqvist O. ERAS-enhanced recovery after surgery: moving evidence-based perioperative care to practice. JPEN J Parenter Enteral Nutr. 2014;38(5):559–66.
Mattei P, Rombeau JL. Review of the pathophysiology and management of postoperative ileus. World J Surg. 2006;30(8):1382–91.
Reismann M, Arar M, Hofmann A, Schukfeh N, Ure B. Feasibility of fast-track elements in pediatric surgery. Eur J Pediatr Surg. 2012;22(1):40–4.
Vrecenak JD, Mattei P. Fast-track management is safe and effective after bowel resection in children with Crohn’s disease. J Pediatr Surg. 2014;49(1):99–102.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing AG
About this chapter
Cite this chapter
Mattei, P. (2017). Enhanced Recovery Protocols. In: Mattei, P., Nichol, P., Rollins, II, M., Muratore, C. (eds) Fundamentals of Pediatric Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-27443-0_6
Download citation
DOI: https://doi.org/10.1007/978-3-319-27443-0_6
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-27441-6
Online ISBN: 978-3-319-27443-0
eBook Packages: MedicineMedicine (R0)