ERAS Research Nurse

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Enhanced Recovery After Surgery (ERAS) is a multimodal, multidisciplinary programme. The main principle of ERAS is to limit surgical stress during the perioperative period. While the essential components of ERAS have been adapted in response to the increasing evidence base and across a variety of specialties, including gynaecological, musculoskeletal and urological surgical procedures, all elements of ERAS are intended to minimise the surgical stress response.

The ERAS or ‘fast-track’ programme was first introduced in Denmark by Professor Henrik Kehlet. He described the multimodal aspects of the ERAS ethos and suggested that focusing on core aspects of surgical recovery could alter patients’ pathophysiological recovery and minimise their surgical stress response, leading to faster patient recovery times (Kehlet 1997).

The principles of ERAS were first introduced in planned or elective surgery because these patients are usually ‘fit and well’ before the procedure, so the pathway is more predictable than in emergency and urgent surgery, thus enabling increased reduction of the surgical stress response. However, some elements of ERAS should be applied in emergency and urgent surgery, such as reduced fasting times, early mobilisation and avoidance of excessive intravenous (IV) fluids. All elective specialties and surgical procedures should follow an ERAS pathway, and ERAS should be considered the default recovery pathway for all surgical patients. The ERAS Society has produced guidelines for a variety of surgical specialties, which are available at: erassociety.org/guidelines/list-of-guidelines. 

In addition to ERAS, other evidence-based interventions have been introduced in surgical units worldwide, such as laparoscopic surgery – also known as minimally invasive or keyhole surgery (Zhuang et al 2013) – and multimodal analgesia or opioid-sparing analgesia, which involves using a variety of techniques such as regional blockade or spinal anaesthesia and IV lidocaine (Ratnaliker et al 2017). These interventions have contributed to improved patient outcomes following elective surgery.

Angie's contact details: 

• Mon – Fri 07:30 – 15:30
• Contact details – angie.balfour@nhslothian.scot.nhs.uk OR angie.balfour@ed.ac.uk. Tel: 07896 2935201