Eras

Enhanced Recovery After Surgery (ERAS)

Enhanced Recovery After Surgery (ERAS) is a surgical technique developed to speed up patients’ treatment, healing, and postoperative recovery. Most labor or delivery operations used ERAS. The surgical procedure does not damage the skin tissue much, and ERAS certainly impacts the postoperative recovery process. The operator will usually also sew the fascia with a one-on-one suture technique so that the damaged tissue can form new skin tissue more easily. The patient will consume sugary drinks hours before the operation, aiming to accelerate the patient’s mobilization from the procedure.

With ERAS, the doctor will also release the adhesions between the tissues to avoid excessive pain immediately after or during the healing process. In addition, the treating doctor will also restore the position of the tissue with end-to-end treatment on the same site using threads and suture techniques that do not interfere with the patient’s movement and postoperative recovery.

All Bunda hospitals have implemented the ERAS anesthesia protocol. With this technique, the postoperative recovery process will be faster, and it minimizes pain, postoperative bowel dysfunction (in colorectal surgery), and immobilization. The type of anesthesia used in patients with the ERAS technique is also specially selected to support rapid recovery using a tiny needle. The dose required varies and depends on the area and the size of the surgery site. However, the anesthesiologist will usually use the lowest amount possible and perform regional anesthesia. ERAS ensure the patient can be active immediately after the procedure, and it takes a short period to return to normal activities. The anesthesiologist will be fully responsible for supervising and providing pain management services during the operation until the patient returns home. The medical staff or the doctor will remove attached devices such as infusions and catheters for 2 hours postoperative. Furthermore, to train motor skills, the patient will start the activities, from sitting, standing, and walking.

In developed countries such as America and Japan, the length of treatment and postoperative recovery with the ERAS technique is a crucial issue, as they are trying to shorten the length of treatment and recovery of patients after surgery. Advantages of ERAS delivery Some of the benefits of giving birth using the ERAS technique include the following:
1. The length of stay in the hospital becomes short
2. 4 hours after surgery, you can start your activities
3. Patients can be given nutrition immediately after surgery
4. Pain and labor pain is very minimal
5. Give birth comfortably
6. Fast recovery

There is also an ERAS technique specified for cesarean section, namely Enhanced Recovery After Cesarean Surgery (ERACS). The recovery steps for surgery with ERACS are as follows:

Pre Operation:
1. Fasting from solid food 6 hours before surgery. It’s still allowed to drink sweet beverages up to 2 hours before surgery
2. Infusion for the administration of fluids and medicines

Intraoperative:

1. Anesthesia is performed in the operating room with a spinal technique
2. The doctor examines the baby immediately after the baby is born to ensure that the baby is healthy, and the doctor will put the baby on the mother’s chest (IMD).

Post Operation:
1. Sit and stand within 1-2 hours after surgery
2. Eat and drink within 2 hours after surgery
3. Remove the catheter so that the patient can use the bathroom within 6-8 hours after surgery
4. Breastfeeding the baby
5. Postoperative blood test