ERAS Society's Guidelines on Perioperative Care: Part 1 - Preoperative Care

11. Pre-operative nasogastric intubation

The experts strongly recommend, “Pre-operative nasogastric tube insertion should be considered on an individual basis assessing for the risk of aspiration and gastric distension depending on the pathology and patient factors.”

12. Patient and family education and shared decision making

The experts recommend,

• “Patients and families should have the opportunity to discuss the risk of surgery with a senior physician (this could be the surgeon, anesthesiologist or intensive care physician) prior to surgery. Counseling should be informed by a validated risk score but with the clear understanding that scores have limitations when applied to individual patients. When appropriate, treatment escalation plans and advance care plans should be discussed and documented.
• Clear, concise, written information or decision aids combined with verbal patient education should be provided to the patient and family before surgery if possible.”

The authors concluded, “These guidelines are based on the best available evidence for an ERAS approach to patients undergoing emergency laparotomy. Initial management is particularly important for patients with sepsis and physiological derangement. These guidelines should be used to improve outcomes for these high-risk patients.”

For further information:

https://link.springer.com/article/10.1007/s00268-021-05994-9