Enhanced Recovery After Surgery (ERAS) Protocol

The Enhanced Recovery After Surgery (ERAS) Protocol is a new approach to surgery preparation and recovery that can help you heal faster, avoid complications, and be less dependent on narcotic pain medications.

Part of the ERAS protocol is to drink nutritional supplements until the day of your surgery. You will also start taking non-narcotic pain relievers to jump-start your pain control response.

Medical studies have shown that taking certain steps before and after your surgery — guided by a team of caregivers each with their own specialties — can help you get home faster and get back to the post-surgery life you were hoping for.

Two weeks before surgery

If you are currently taking an anticoagulant, antiplatelet, or blood thinner, you should contact the prescribing physician and your surgeon to find out when to stop the medication before surgery. These drugs may include aspirin, Plavix (clopidogrel), Coumadin (warfarin), Eliquis (apixaban), or Xarelto (rivaroxaban).

Stop all decongestants, nasal sprays, Alka-Seltzer, Pepto Bismol, vitamins, diet pills, and herbal supplements.

Seven days before surgery

Stop taking nonsteroidal anti-inflammatory drugs. This includes naproxen (Aleve), ibuprofen (Advil, Motrin), meloxicam (Mobic), oral or gel diclofenac, and celecoxib (Celebrex).

Five days before surgery

If someone from the pre-admission tests hasn’t called you yet, call (502) 446-8660.

Start using Bactroban (mupirocin) nasal ointment once in the morning and once in the evening. A prescription for this medication will be sent to your pharmacy before your surgery date. Put a pea-sized amount on a cotton swab and apply it inside each nostril. (In case of redness, irritation, allergy or intolerance to medication, inform your surgeon and stop using the ointment.)

Four days before surgery

Continue to use Bactroban (mupirocin) nasal ointment, once in the morning and once in the evening.

Stop shaving at or around your surgical site.

Shower with chlorhexidine gluconate (CHG) soap using a clean washcloth. Wash first with your usual soap, then with the CHG, leaving the CHG on your skin for one minute before rinsing off with warm water. Dry with a clean towel. Keep CHG soap out of your eyes, ears, nose, and mouth and away from your genitals. Stop using CHG if you have an allergic reaction. If this happens, switch to an antibacterial soap, such as Dial. Dry yourself off with a clean towel.

Three days before surgery

Continue to use Bactroban (mupirocin) nasal ointment, once in the morning and once in the evening.

Shower with CHG using a clean washcloth. Dry yourself off with a clean towel.

Two days before surgery

Continue to use Bactroban (mupirocin) nasal ointment, once in the morning and once in the evening.

Shower with CHG cleanser using a clean washcloth. Dry yourself off with a clean towel.

One day before surgery

Finish by using Bactroban (mupirocin) nasal ointment, once in the morning and once in the evening.

Shower with CHG using a clean washcloth. Dry yourself off with a clean towel.

Put on clean pajamas and sleep on clean sheets.

Follow the instructions for your medications.

Remove all jewelry (including wedding rings) and leave them at home.

  • 8:00 p.m.: Drink a pre-op nutrition drink.
  • 10:00 p.m.: Drink a pre-op nutrition drink.
  • At bedtime: Take 1,000 milligrams of acetaminophen (Tylenol).
  • Do not eat after midnight.
  • Do not smoke or use tobacco after midnight.

Day of surgery

Follow your medication instructions as discussed with your pre-admission testing nurse.

Two hours before your scheduled surgery time, drink your last pre-op nutrition drink.

Do not drink anything for two hours before your surgery, including water and coffee.

Shower with CHG just before leaving for the hospital, using a clean washcloth and pat dry with a clean towel.

Do not use mascara, makeup, lotion, powder, perfume, deodorant or aftershave.

Bring your continuous positive airway pressure (CPAP) machine, inhalers, goggles (non-contact), dentures and hearing aids, if you use them.

Bring photo ID, your insurance card and a copayment, if you have one.

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