ERAS schedules | General schedules | |
---|---|---|
Admission | ||
Parent education | Dietary and analgesic guidance, and alleviation of parents’ anxiety | Conventional admission education |
Analgesia | Oral analgesia | No requirement |
Nutrition | Pediatric nutritional risk assessment (PNYS) and nutrition intervention | No requirement |
Detumescence | Elevation, cold compresses, fist-clenching guidance, without decongestants | Elevation and ice compresses in the presence/absence of decongestants, decided by surgeons |
Before surgery | ||
Skin preparation | Preoperative skin cleaning without hair removal | No requirement |
Fasting and water deprivation time | No light drinking for 2 h, no breast milk for 4 h, no solid carbohydrates for 6 h, and no fat or protein intake for 8 h | Fasting and water deprivation for 8 h |
Carbohydrate loadinga | Intravenous infusion of 4:1 glucose and sodium chloride after fasting | Fluid supplementation for hungry pediatric patients |
Catheterization and intestinal preparation | No catheterization and intestinal preparation | Decided by surgeons |
Nerve block | Interscalene brachial plexus block | No requirement |
During surgery | ||
Tubing and drainage | No incision drainage tube or reduction of other tubes | Drainage tube use decided by surgeons |
Body temperature | Contimuous body temperature monitoring and thermostatic blanket use during surgery | No requirement of continuous monitoring |
Reduce the risk of bleeding | Tourniquet use during surgery | No requirement |
Analgesia | Interscalene brachial plexus block, analgesic pump, and regular oral pain medications | Pain medication as required, an analgesic pump decided by parents, no requirement for nerve block |
After surgery | ||
Food intake | Fasting after waking | Fasting and water deprivation after waking for 2 h |
Tube drawing | Drawing of infusion tube 1 day after surgery | Tube drawing time point decided by surgeons |
Nutrition | Reassessment and intervention after surgery | No requirement |
Carbohydrate loading | Discontinuation of parenteral nutrition 1 day after surgery | Energy supplement discontinuation time point decided by surgeons |
Postoperative dressing change and discharge | Dressing change on the 2nd and 4th days and discharge on the 4th day | Decided by surgeons |
Removal of Kirschner wires and plaster as well as functional exercise guidance in the 4th–5th weeks | Removal time of fixtures decided by surgeons | |
Post-discharge compliance | Regular telephone and outpatient follow-up after discharge | Regular outpatient follow-up after discharge |