The meaning. ERAS stands for “Enhanced Recovery After Surgery”.
The protocol. ERAS is a standardised protocol for patient management before, during and after surgery. It is based on a standardised and evidence-based, multidisciplinary and collaborative approach, which focuses on: - Education and patient involvement, - Optimisation of perioperative nutrition, - Standardisation of the perioperative anaesthetic programme, - Attenuating stress, - Early mobilisation and oral nutrition.
ERAS has multiple objectives: reducing the patient's surgical stress to a minimum by using all scientifically proven and validated means; reducing postoperative complications; providing better pain management and faster return to autonomy. To achieve this, efficacy is improved by taking into account the pre-, intra- and postoperative phases and drugs, intravenous fluids and postoperative nausea and vomiting are minimised. Similarly, the patient actively participates in his/her management throughout the process. Thus, his/her experience and satisfaction are improved, thereby reducing variability in care.
Historically, the ERAS principles were described in Scandinavia in the 1990s as multimodal surgical care and were initially called “Fast track surgery”. After a decade of evolution, a multidisciplinary and international working party began using the term ERAS. The working party discovered that traditional practices vary greatly depending on the centre and that these current practices differ from those recognised as standard. The group developed and published evidence-based consensus protocols, initially for certain types of gastrointestinal surgeries. The ERAS Society was officially created in 2010 while the first training centre was established at the Centre Hospitalier Universitaire Vaudois (CHUV, University Hospital of Vaud) in Lausanne in 2011. The Clinique Générale-Beaulieu began its certification procedure in 2013 and was among the first private clinics in Switzerland to be certified in June 2014.