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Table 1 Components of non-ERAS Traditional care program and ERAS program

From: Comparative short-term outcomes of enhanced recovery after surgery (ERAS) program and non-ERAS traditional care in elderly patients undergoing lumbar arthrodesis: a retrospective study

Comparisons ERAS Program non-ERAS Traditional care Program
Preoperative
 Education Including the purpose, workflows and benefits of ERAS program, anticipated postoperative pain and expectations and risks of surgery, through verbal and handouts Routine consultation
 Nutritional counselling Nutrition screening during the perioperative period, including nutrition screening tools and laboratory indicators. Dietitians provide personalized diet guidance and nutritional supplement to patients in need Not standardized
 Fasting Clear fluids including carbohydrate drink allowed up to 2 h before surgery Fasting for 10 h before surgery
 Antithrombotic prophylaxis Active/passive limb movement and antithrombotic stockings Active/passive limb movement
 Antimicrobial prophylaxis Antibiotic prophylaxis within 1 h of incision Antibiotic prophylaxis within 1 h of incision
Intra-operative
 Tranexamic acid Used routinely Not standardized
 Standard general anesthetic protocol Multimodal analgesia; TIVA-based anesthetic technique with propofol, lidocaine, ketamine, ketorolac, antiemetics and with up to 0.5% MAC inhaled anesthetics, avoid N2O; Depth of anesthesia monitoring Not standardized
 Avoidance of salt and water overload Goal-directed euvolemia Euvolemia
 Maintenance of normothermia Keeping core temperature at 36–37 °C Not standardized
 local infiltration analgesia Used routinely Not standardized
Postoperative
 Early ambulation In-bed mobilization within 4 h after surgery; Encourage ambulation after 4 h; Early treatment with physical therapists Recommended to rest in bed for 1–2 days
 Early removal of bladder catheter Remove the bladder catheter when returning to the ward Remove the bladder catheter when ambulation
 Early oral feeding Oral feeding at will after recovery from anesthesia Oral feeding on postoperative day 1
 Postoperative multimodal analgesia Adequately controlled pain; visual analog scales < 4: no analgesia or oral minimal dose of nonopioid; visual analog scales: 4–6: oral or intravenous nonopioid; visual analog scales ≥7: opioid According to patient needs; opioid was commonly used
 Stick to Discharge Criteria Discharge Criteria: no clinical complications; Visual analog scales <3 with oral analgesics; Independent ambulation or ambulation with minimal assistance; Adequate nutrition intake No definite discharge criteria