Item | Enhanced Recovery After Surgery | Prehabilitation |
Preoperative optimization |
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Nutrition and metabolic optimization, such as personalized counselling and targeted interventions to reduce nutrition-impact symptoms (e.g., nausea) and supplementation to correct malnutrition Physical optimization to enhance cardiorespiratory capacity, build strength, and preserve function through exercise classes or home exercise programs Psychologic preparation and stress reduction, such as deep-breathing exercises, visualization techniques and emotional support
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Preoperative patient education |
Surgical logistics and what patients can expect during their hospital stay Prepare patients to partake in patient-oriented ERAS elements, including early mobilization Answer patient questions during the education session
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Explain why it is important to prepare for surgery and how to optimize nutrition, exercise and mental health before surgery Correct misconceptions such as fad diets and that exercise must involve gym attendance Be available to answer questions and offer regular support (e.g., telephone calls) throughout the perioperative period
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Additional suggestions from patients |
Consider offering the preoperative ERAS education as a group class Involve partners and caregivers Involve peers with surgery experience Discuss postdischarge limitations, such as weightlifting restrictions, so that patients can be prepared to recover well at home (e.g., buying groceries, and preparing and freezing meals) Provide instructions and demonstrations so patients feel comfortable getting out of bed and coughing after surgery
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Involve partners and caregivers for additional support and encouragement Consider group classes, such as information sessions on nutrition or meditation, and exercise classes to encourage social support Include a peer with surgery experience on the team to reinforce the benefits of nutrition, exercise and psychologic preparation, as well as augment emotional support Focus on personal recovery goals Listen to concerns
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