Recovering After Surgery

We are strong proponents of Enhanced Recovery After Surgery (ERAS) protocols and techniques.

After surgery, post-operative soreness and pain at the site of surgery is expected and can vary from person to person and depending on the surgery.
All efforts will be made to ensure pain is controlled with multi-modal analgesia, which is using all different types of medications in combination to address the different aspects of pain including muscle spasm, nerve pain, inflammation.
While opioid medications are known to be useful for pain after surgery, they are associated with many side effects including nausea, vomiting, constipation, urinary retention, ileus, orthostatic hypotension, delirium, and oversedation. We make every effort to control post-operative soreness and pain with all alternative medications and methods to avoid these dangerous side effects.

Early post-operative mobilization and walking is associated with (See Zaharia et al. ):
- Decreased length of stay with discharge home
- Decreased risk of urinary retention, urinary tract infection, and ileus
- Decrease in 30 and 90 day hospital re-admissions.
In a landmark JAMA study, increased daily step counts were associated with significant decreases in mortality rates, with the benefit increasing as step count increased. (See Saint-Maurice at el.)

Following surgery, returning to oral intake of nutrition is recommended to ensure continued GI health and motility.
A balanced diet is recommended to improve recovery and promote wound healing. Need for all macronutrients are higher after surgery with protein requirements being elevated up to 250% above normal (See Ghaly et al.).
Micronutrients (vitamins, minerals, amino acids) are also critical as deficiencies can impair wound healing. Supplementation may be indicated to ensure the best possibility of rapid wound healing.

The human body is approximately 60% water by weight, so fluid intake before and after surgery play a major role in your recovery.
Multiple studies looking at post-operative hydration in surgical patients have found that intravenous fluids can increase risk of post-operative symptoms as well as complications (See Gustafsson et al.)
Therefore, ERAS protocols have encouraged measures to reduce post-operative nausea and encourage oral intake of fluids, rather than intravenous fluids, in the hours after surgery.

Apex Brain & Spine Neurosurgical Specialists