Enhanced recovery after surgery (ERAS)

Meet the patient

This morning's right hemicolectomy is on the ERAS pathway. Preassessment corrected her iron-deficiency anaemia and she stopped smoking six weeks ago. She takes a carbohydrate drink at 06:00 for a 09:00 induction, and the plan is to walk her this evening and feed her tonight.^[1]

Two questions decide every ERAS stem: which bundle elements does the anaesthetist own? and what ruins the pathway? The honest answers are "about a third of them, alongside the surgeons and the ward" and "low adherence, not a missing drug" — and examiners are listening for exactly that systems thinking.^[1]

References4ShowHide

1. [1]Gustafsson UO et al. Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations 2025 Surgery, 2025.PMID 40783294
2. [2]WOMAN Trial Collaborators Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial Lancet, 2017.PMID 28456509
3. [3]Neal JM et al. The Third American Society of Regional Anesthesia and Pain Medicine Practice Advisory on Local Anesthetic Systemic Toxicity: Executive Summary 2017 Reg Anesth Pain Med, 2018.PMID 29356773
4. [4]Nelson G et al. Enhanced recovery after surgery (ERAS®) society guidelines for gynecologic oncology: 2026 update. Gynecol Oncol, 2026.PMID 42247726