Enhanced Recovery Protocol For Your Upcoming Surgery

This is a clinical pathway formulated by your care team. This care team includes your surgeon and your anesthesiologist. An anesthesiologist is the doctor who monitors your breathing and keeps you asleep, comfortable and monitors your vital signs in the operating room. Our goal is to keep you safe, for your pain optimally controlled, and to help you return home quickly after surgery. This pathway works before, during, and after your surgery.

Before Your Surgery:

1. We want you to stop smoking at least 4 weeks prior to surgery. This decreases your risks for lung complications during surgery and your recovery.
2. You may receive medication to help regulate your bowel function prior to surgery. This helps prevent your intestines from slowing down due to the surgery.
3. You may receive a special anti-microbial soap to bathe with the night before or the morning of surgery. This is to decrease your risk of a surgical site infection.
4. The night before the surgery, you will be able to eat regular foods up until midnight.
5. Depending on your surgeon and your anesthesiologist, you may be able to drink Powerade 2 hours prior to your surgery.
6. You will take pain medications the morning of your surgery to help control your pain when you wake up and help reduce inflammation
7. You may receive some medications to take before surgery to help with nausea after you wake up from surgery.

During Your Surgery:

1. . Our goal is to use the least invasive route we can, to safely perform your surgery. For hysterectomies, these include vaginal hysterectomies or laparoscopic hysterectomies.
2. We minimize the amount of time your urinary bladder catheter is in place.
3. You will receive pain and nausea medications to help you wake up with less pain and nausea.
4. You will wear devices on your legs called, Sequential Compression Devices (SCDs), to prevent blood clots that rarely form during surgery.
5. Your blood pressure and vital signs will be closely monitored to decrease the rare complications of heart attack, stroke, and kidney problems.
6. Your surgeon can inject a numbing medication around your incision to help control your pain when you wake up.

After Your Surgery:

1. We will remove your urinary bladder catheter as early as safely possible.
2. For gynecologic surgeries, patients are often discharged later the same day.
3. If you stay in the hospital, you will continue to wear Sequential Compression Devices on your legs to prevent blood clots from forming after surgery. Sometimes you may need a blood thinner injection in the stomach to prevent blood clots.
4. Our biggest focus after your surgery is your pain control. Our goal is to minimize your use of certain pain medications, called opioids. These can contribute to dizziness, drowsiness, confusion, delayed intestine function, constipation, decreased respiratory function, and be habit forming. We can use medications such as those listed below to safely control your pain.
   1. Tylenol (acetaminophen), Toradol (ketorolac), Celebrex (celecoxib), and Neurontin (gabapentin)

AUTHOR

Holly Eliason, DO