| Pre-operative interventions |
Operative interventions |
Post-operative interventions |
| 1. Evaluating existing health status |
1. Pre-medications with appropriate drugs (like anxiolytics, anti-emetics, antacids, pro-kinetics, etc.) |
1. Multi-modal Analgesia to achieve a state of minimal or no pain |
| 2. Adequate nutritional support |
2. Use of thoracic epidural Analgesia |
2. Post-operative nausea and vomiting pharmaco-prophylaxis |
| 3. Smoking cessation |
3. Avoiding or selective use of nasogastric tube, urinary catheter or abdominal drains |
3. Patient to be rendered tube/catheter/drain free as soon as possible |
| 4. Exercise regime |
4. Goal-directed fluid administration (preventing both over and under hydration) |
4. Early enteral nutrition |
| 5. Education regarding procedure and protocol |
5. Maintaining intra-operative Normothermia |
5. Enforced Ambulation |
| 6. Minimal starvation time (2h-liquids and 6h-solids) |
6. Surgical techniques (like Minimal tissue handling, Minimize operative time, Minimal access surgery) |
6. Discharge when decided criteria met. |
| 7. Pre-operative oral carbohydrate loading |
7. Other measures like infiltration of wound site with local anaesthetic at end of surgery |
7. Ensure follow-up |
| 8. Avoiding mechanical bowel preparation. |
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