From: Feasibility of enhanced recovery after surgery in gastric surgery: a retrospective study
Operative day | -1 | 0 | +1 | +2 | +3 | +4 | +5 | +6 | +7 |
Preoperative counseling | Preoperative counseling was held in the outpatient clinic before hospitalization and in the ward after admission. | ||||||||
Pre-medication | Patients do not receive any sedation. | ||||||||
Oral intake | Normal diet until midnight | Oral hydration solution (OS-1®) 3 h before surgery | Drink a water and oral nutrition supplement (Endure Liquid®) | Liquid diet (3 steps up to a soft diet every 2 days) | |||||
Bowel preparation | 1 g magnesium oxide and a New Lecicarbon® suppository | ||||||||
Anesthesia and Analgesics | Combination of epidural analgesia (TH7-11) and general anesthesia during surgery | ||||||||
Continuous thoracic epidural infusion of analgesics after surgery | → | Removing epidural catheter | |||||||
Nonsteroidal anti-inflammatory drug intravenously after surgery twice daily | → | Acetoaminophen three times a daily orally | → | → | → | ||||
Drain and NGT | No drain in distal gastrectomy, one or two drains in total gastrectomy | Removing drain(s) | |||||||
NGT was removed immediately after surgery | |||||||||
Urinary catheter | Removing | ||||||||
ADL | Encourage to sit out of bed for more than 6 h | Encourage to walk the length of the ward | → | → | → | → | → | ||
Antithromboprophylaxis | None | Subcutaneous injection of antithrombotic agent (enoxaparin sodium or fondaparinux) | → | → | None | → | → | ||
X-ray and blood exam. | ○ | ○ | ○ (Check discharge creiteria) |