How do you
improve the opera-
tions of your outpa-
tient surgery center to
address those three
factors? The answers
are quite straightfor-
ward.
Streamline the
experience
To succeed with
ERAS, you need to be
very aggressive in man-
aging pain, nausea and vomiting.
• Stay ahead of the pain. Traditionally in outpatient settings,
patients receive IV painkillers upon arrival in PACU, which immedi-
ately causes nausea and vomiting in some patients and can ultimately
delay discharge.
In an enhanced model, you take an entirely different approach. The
strategy is to upload the patient with oral pain medication before the
surgery starts. These drugs usually take 30 to 60 minutes to work, so
they are already in the patient's system and working efficiently in the
OR, managing the pain of the patient very well.
When patients arrive in the PACU, they don't need IV opioids. That
lowers the risk of PONV along with the additional time in PACU
required to treat it. Plus, it's always better to use opioids as sparingly
as possible.
• Pre-op carb loading. It's safe to assume that patients don't like
going "NPO after midnight" and, quite frankly, they shouldn't endure
J U L Y 2 0 2 0 • O U T P A T I E N T S U R G E R Y . N E T • 4 5
UP AND OUT Enhanced Recovery After Surgery (ERAS) protocols can help outpa-
tient facilities get patients from the OR to the PACU and back home more quick-
ly than ever.
