Enhanced Recovery After Surgery (ERAS)

The pediatric surgeons at Children’s Wisconsin are one of several groups in the country that use a special program called Enhanced Recovery After Surgery (ERAS) for children having major surgeries on their abdomen (belly).

What is Enhanced Recovery After Surgery (ERAS)?

ERAS is a program to help your child get better as fast as possible after abdominal (belly) surgery. There are steps to follow before and after surgery. This includes walking and drinking liquids. These steps help the intestines heal faster and help your child get back to normal as quickly as possible. The program is based on research. It has been used on both adults and children.
What does my child need to do before surgery?

• Eat and drink normally the day before surgery.
• To help prevent infection, your child should have a bath the evening before surgery. You will also get pre-op wash wipes to use. We will teach you how to use them.
• On the day of surgery, your child will drink clear liquids before coming to the hospital. Clear liquids are drinks that you can see through. This helps to make sure your child is hydrated (the body has enough water) before surgery.
• It is important that your child does not get dehydrated. Drinking before surgery is a big part of the ERAS program. Stop drinking liquids 2 hours before their scheduled time for surgery.
• Take any medicines the doctor says are needed.

What do I need to do before my child’s surgery?

• Sign up for MyChart. MyChart helps us talk to each other when your child is at home.
• Follow the instructions from the doctor. A nurse will call 1 to 3 days before surgery to review instructions. It is very important that you follow the instructions.

What will the doctor do during surgery to help my child’s recovery?

• Use anesthesia medicines that let the intestines keep working normally.
• Use the smallest cuts possible.
• Wash up carefully. This helps to limit the chance of infection after surgery.
• Keep your child’s body temperature as normal as possible.
• Keep the amount of fluids in the body as normal as possible.
• Take out tubes and drains in the body when they are not needed.

What will my child need to do after surgery?

• Start drinking soon after surgery. Once your child drinks enough fluids without any problems, they will get to eat food.
• Get out of bed and walk around soon after surgery. Your child will need to walk 1 or 2 times on the day of surgery. After that, your child will need to walk at least 4 times every day.
• Older children may need medicine or boots that squeeze their legs. This helps to keep blood clots from forming.
• Some children will need special tubes or an ostomy pouch after surgery. Your child’s doctor will tell you if that will happen to your child.

How will my child’s pain be treated?

We know that having surgery is never pain-free.

• Medicines will be used that have fewer side effects. These medicines are often given on a schedule.
• Opioid (narcotic) pain medicines will be used as little as possible. These medicines have more side effects like constipation, sleepiness, and shallow breathing.
• Other medicine may be used if your child feels sick to their stomach or is throwing up. 

When will my child be able to go home?

Your child will be able to go home when:

• They have no fever.
• They are drinking enough to stay hydrated.
• They are able to walk around several times a day or are back to moving around like they usually do.
• Their pain is controlled with medicines that are taken by mouth.

It is important that you are ready to take care of your child. Your child will not be fully back to normal when it is time to leave the hospital. They may still have some pain and may not be eating like normal yet. It is still better and safer to finish your child’s full recovery at home.

What happens when we go home?

• The clinic staff will call you after you go home to check that your child is doing okay.
• Your child will be seen for a clinic visit about 1 month after surgery.
• Call the clinic or use MyChart if you have any questions or concerns.
• Only go to the Emergency Room if there is an emergency like fainting or not responding, severe abdominal pain, or uncontrolled throwing up.