Enhanced Recovery After Surgery (ERAS) is a multimodal approach to surgical care that focuses on improving patient outcomes, reducing complications, and accelerating recovery following surgery. The ERAS protocol is a comprehensive care pathway that aims to optimize each step of the patient's surgical journey, from preoperative preparation to postoperative recovery.

    The concept of ERAS was first introduced in the early 1990s by Dr. Henrik Kehlet, a Danish surgeon who recognized the need for a more patient-centered approach to surgical care. The traditional approach to surgery often involved prolonged hospital stays, restricted diets, and immobilization, which could lead to complications such as infections, blood clots, and delays in recovery. Kehlet's vision for ERAS was to transform surgical care into a more efficient, evidence-based, and patient-focused model that would improve outcomes and enhance the overall patient experience.

    The ERAS protocol involves a team-based approach to care that includes surgeons, anesthesiologists, nurses, and other healthcare professionals working together to provide comprehensive care to the patient. The protocol is designed to be flexible and adaptable to the needs of each individual patient, taking into account their unique medical history, surgical procedure, and recovery goals.

    Preoperative Phase: The ERAS protocol begins with the preoperative phase, which involves optimizing the patient's physical and psychological health prior to surgery. This may include smoking cessation, weight loss, nutritional counseling, and exercise programs to improve the patient's overall health and fitness. In addition, patients may receive education and information about their upcoming surgery, including what to expect during their hospital stay and how to manage their pain and other symptoms.

    Intraoperative Phase: The intraoperative phase of the ERAS protocol focuses on minimizing surgical stress and reducing the risk of complications during surgery. This may involve the use of minimally invasive surgical techniques, regional anesthesia, and other strategies to reduce pain, minimize blood loss, and shorten the duration of surgery.

    Postoperative Phase: The postoperative phase of the ERAS protocol is designed to promote rapid recovery and prevent complications following surgery. This may involve early mobilization, aggressive pain management, and early feeding to promote bowel function and prevent complications such as ileus. In addition, patients may receive ongoing support and education about their recovery, including strategies for managing pain, preventing complications, and achieving their recovery goals.

    The ERAS protocol has been shown to improve outcomes and reduce complications following surgery in a variety of settings, including colorectal surgery, gynecologic surgery, and orthopedic surgery. Studies have demonstrated that ERAS can reduce the length of hospital stay, reduce the risk of complications, and improve patient satisfaction with their surgical care.

    In addition to improving patient outcomes, the ERAS protocol can also have significant economic benefits. By reducing the length of hospital stay and the risk of complications, ERAS can help to reduce healthcare costs and improve the efficiency of healthcare delivery.

    In conclusion, Enhanced Recovery After Surgery (ERAS) is a comprehensive care pathway that is designed to improve patient outcomes, reduce complications, and accelerate recovery following surgery. The ERAS protocol involves a team-based approach to care that is flexible and adaptable to the needs of each individual patient. By optimizing each step of the patient's surgical journey, from preoperative preparation to postoperative recovery, ERAS can help to transform surgical care into a more efficient, evidence-based, and patient-centered model that benefits both patients and healthcare providers.