Perioperative and postoperative orders for enhanced recovery after surgery pathway
| Type of order | Day | ||
|---|---|---|---|
| Preoperative; postoperative day 0 | Postoperative day 1 | Postoperative days 2 and 3* | |
| Pain control | Intercostal block favoured with PCA Epidural offered at surgeon’s discretion | Discontinue PCA Discontinue epidural if performed Pain control with oral opioids | |
| Interventions | Discontinue suction on drain If absence of air leak and drainage < 350 mL in 24 h, discontinue drain and discharge patient | If absence of air leak and drainage < 350 mL in 24 h, discontinue drain and discharge patient | |
| Nursing care | Do not insert Foley unless specifically requested by surgeon Remove arterial line before sending to the floor Drain at −20 mm H20 suction Diet as tolerated started 6 h postoperatively Incentive spirometer every 1 h Transfer patient to chair the night of the operation | Ambulate patient 2 times in 24 h | Ambulate patient at least 3 times in 24 h (complete hallway) |
| Investigations and tests | Chest x-ray in recovery room | Complete blood count, chemistry 7 panel Chest x-ray | |
PCA = patient-controlled anesthesia.