Table 1 ERAS protocol used for RACE study
Item | Standard | Optional |
|---|---|---|
1. Pre-operative: extensive counselling patient | ✓ | |
2. Correction anaemia (Hb ≥ 6 mmol/l) | ✓ | |
3. Pre-operative consult dietary specialist | ✓ | |
4. Quit smoking | ✓ | |
5. Physical exercise before surgery | ✓ | |
6. Pre-operative enema: 12 h before surgery (in case of constipation) | ✓ | |
7. Pre-operative: High calorie fluids, until 2 h before surgery | ✓ | |
8. Pre-operative: solid food until 6 h before surgery | ✓ | |
9. Pre-operative: clear fluids, until 2 h before surgery | ✓ | |
10. Epidural analgesia (thoracal) until max 72 h after surgery | ✓ | |
11. Antibiotic prophylaxis, one-shot pre-operative Cefazoline (≤80 kg 1 g; > 80 kg 2 g) + Metronidazole (500 mg). May be repeated if the operation time is longer than the half-life | ✓ | |
12. Anaesthetic considerations Normothermia, Goal directed fluid therapy, normovolemia, short acting sedatives, minimalize opioids. | ✓ | |
13. Post-operative: nasogastric tube removed directly after surgery | ✓ | |
14. Post-operative: start laxantia post-op day 1 | ✓ | |
15. Post-operative: chewing gum | ✓ | |
16. Post-operative: standard anti-emetica | ✓ | |
17. Post-operative: start mobilisation 6 h after surgery | ✓ | |
18. Post-operative: fluid diet until first stool | ✓ | |
19. Post-operative: Thrombosis prophylaxis for four weeks with ‘low molecular weight heparin’ = LMWH (Fraxiparine 0,6 cc) | ✓ |