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

  • Akira TokiEmail author


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.



ERAS Children 


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© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Division of Pediatric Surgery, Department of SurgeryShowa University School of MedicineTokyoJapan

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