Skip to main content

Enhanced Recovery After Surgery (ERAS) for Postoperative Pediatric Surgical Disorders

  • Chapter
  • First Online:
Enhanced Recovery after Surgery
  • 1646 Accesses

Abstract

The purpose of ERAS protocol for children is less invasive operation, prevention of complication, promotion of recovery after surgery, and good mental, physical development. The most important factors of ERAS for children are avoidance of prolonged fasting, nonroutine use of tubes or drains, and early oral nutrition and mobilization. We described in detail about these important factors:

  1. (1)

    Avoidance of prolonged fasting: General fasting standards were 2 h for clear fluids, 4 h for breast milk, 6 h for nonhuman milk/cow milk and solid substances, and 8 h for meat/fried or fatty foods. However, the Japanese guideline does not clearly show fasting time.

  2. (2)

    Nonroutine use of tubes and drains: The non-drainage patients after large volume intraperitoneal lavage for perforated appendicitis were found to have a faster postoperative recovery. Reasons given were a control of bacterial proliferation due to physical reduction in intraperitoneal bacteria count and faster wound healing since a drainage tube is not inserted.

  3. (3)

    Early oral nutrition and mobilization: Postoperative management for infants has changed from intravenous nutrition to early oral nutrition. We describe about dietary fiber as important nutrient.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  1. Shinnick JK, Short HL, Heiss KF, et al. Enhancing recovery in pediatric surgery: a review of the literature. J Surg Res. 2016;202(1):165–76.

    Article  PubMed  Google Scholar 

  2. American Society of Anesthesiologists Committee. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anesthesiologists committee on standards and practice parameters. Anesthesiology. 2011;11:495–511.

    Google Scholar 

  3. Smith I, Kranke P, Murat I, Smith A, et al. Perioperative fasting in adults and children: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol. 2011;28:556–69.

    Article  PubMed  Google Scholar 

  4. Royal College of Nursing. Perioperative fasting in adults and children: an RCN guideline for the multidisciplinary team. London: Royal College of Nursing; 2005. p. 1–18.

    Google Scholar 

  5. S¢reide E, Eriksson LI, Hirlekar G, et al. Pre-operative fasting guidelines: an update. Acta Anaesthesiol Scand. 2005;49:1041–7.

    Article  Google Scholar 

  6. Merchant R, Chartand D, Dain S, et al. Guidelines to the practice of anesthesia revised edition. Can J Anesth. 2012;59:63–102.

    Article  PubMed  Google Scholar 

  7. Woods DM, Macpherson R. Australian and New Zealand guidelines for preoperative fasting. Anaesth Intensive Care. 2007;35:622–3.

    CAS  PubMed  Google Scholar 

  8. Guidelines from Japanese Society of Anesthesiologists. 2012. http://www.anesth.or.jp/guide/pdf/guideline-zetsuinshoku.pdf.

  9. Brady M, Kinn S, Ness V, et al. Preoperative fasting for preventing perioperative complications in children. Cochrane Database Syst Rev. 2009;7:CDOO5285.

    Google Scholar 

  10. Toki A, Ogura K, Horimi T, Tokuoka H, Todani T, Watanabe Y, Uemura S, Urushihara N, Noda T, Sato Y, Morotomi Y, Sasaki K. Peritoneal lavage versus drainage for perforated appendicitis in children. Surg Today. 1995;25:207–10.

    Article  CAS  PubMed  Google Scholar 

  11. Mochizuki H, Trocki O, Dominioni L, et al. Mechanism of prevention of postburn hypermetabolism and catabolism by early enteral feeding. Ann Surg. 1984;200:297–310.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Brassoulis G, Filippou O, Hatzi E, P passotiriou I, Hatzis T. Early enteral administration of immunonutrition in critically ill children: result of a blinded randomized controlled clinical trial. Nutrition. 2005;21:799–807.

    Article  Google Scholar 

  13. Kudsk KA, Croce MA, Fabian TC, Minard G, Tolley EA, Poret HA, Kuhl MR, Brown RO. Enteral versus parenteral feeding: effects on septic morbidity after blunt and penetrating abdominal trauma. Ann Surg. 1992;215:503–11.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Toki A, Watanabe Y, Sasaki K, Wang ZQ. The role of dietary fiber in chemically defined diets. Jpn J Pediatr Surg. 1999;31:678–83.

    Google Scholar 

  15. Brown RC, Kelleher J, Losowsky MS. The effect of pectin on the structure and function of the rat small intestine. Br J Nutr. 1979;42:357–65.

    Article  CAS  PubMed  Google Scholar 

  16. Sakata T, Yajima T. Influence of short chain fatty acids on the epithelial call division of digestive tract. Am J Exp Physiol. 1984;69:639–48.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Akira Toki .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer Nature Singapore Pte Ltd.

About this chapter

Cite this chapter

Toki, A. (2018). Enhanced Recovery After Surgery (ERAS) for Postoperative Pediatric Surgical Disorders. In: Fukushima, R., Kaibori, M. (eds) Enhanced Recovery after Surgery. Springer, Singapore. https://doi.org/10.1007/978-981-10-6796-9_12

Download citation

  • DOI: https://doi.org/10.1007/978-981-10-6796-9_12

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-6795-2

  • Online ISBN: 978-981-10-6796-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics