Frequently Asked Questions

The Enhanced Recovery pathway helps you to recover quickly and lowers the chances of you having any problems after your surgery. This pathway also helps you and your team work together to:

• Help you go home the same day as surgery when possible
• Keep your pain level under control
• Help you get out of bed and walk after surgery more quickly
• Minimize the risk of post-operative nausea and vomiting
• Listen to your concerns and explain things clearly
• Make sure you are happy with the care you get at UNC

No, they are simply what is expected best practice. There is no ongoing “experimentation” though we do continue to refine, enhance and do research using our protocols in order to ensure the best quality of care possible for our patients.

After discussing your surgery with the surgeon, a member of your surgeon’s team will provide you with a special carbohydrate drink that you will drink on the day of surgery, as well as talk with you about ERAS. Next, an appointment will be made for you in the Pre-Care Clinic. In the Pre-Care Clinic, you will have blood work performed and receive additional preoperative instructions.

You will be carefully monitored in the OR during your surgery. An anesthesiologist and another anesthesia provider, a resident doctor or nurse anesthetist, will be watching over you at all times. This anesthesiology team will be also be giving you medicines to keep you asleep and comfortable. You may also receive other medications during your surgery such as medicine to help control your blood pressure and medicines to prevent nausea after surgery. Warm blankets, warm IV fluids and air warmers keep you warm during your surgery. Your blood pressure is closely watched to reduce your risk for heart attack, stroke, and kidney problems.

After your surgery, you will go the Postoperative Anesthesia Care Unit, called the PACU. PACU nurses will be with you to closely watch your vital signs (blood pressure, heart rate, and oxygen levels). Your nurses will also give you any medicines you need. Your UNC team will update your family on how you are doing. When you are ready, you will be moved to a post-operative surgical unit in the hospital for your recovery. It is important for you to get out of bed, sit in a chair, and walk starting the day after your surgery. Do this as often as you can. Your nurse will help you move around safely. If possible, your bladder catheter and your nasogastric “NG” tube will be taken out the day after your surgery. Your UNC surgery team will tell you when you can start drinking fluids and eating solid food. Your team will tell you when it is safe for you to go home.

The nerves that supply the feelings of sensation and pain start in the spinal cord. These nerves leave the spinal cord through a space called the “epidural space.” This space is just a few centimeters under your skin beneath the bones of your spine.An epidural for pain management is a tube, called a catheter, that is put in the epidural space. This small catheter coats the nerves that supply the sensation of pain with a numbing medicine. This medicine blocks the pain until the catheter is taken out. This will make you numb on your belly, but you can still feel and move your arms and legs. A special pump is attached to the tubing. The pump gives you medicine through your epidural to keep you comfortable. This kind of pain control lowers the need for other pain medicines that have more side effects, like nausea, sleepiness and itching.

You may or may not receive an epidural. If it is indicated for your surgery and if it is appropriate for you to get one, then your epidural will be put in before you go to the OR. Before it is put in, you will get a medicine to help you relax and lower any anxiety you may be feeling. Being relaxed will help you stay in the right position while your epidural is being put in.

You will be sitting up in bed with your shoulders and upper back slouched while your epidural is put in. It is important for you to sit very still while the epidural is being placed. The only pain you will feel is a small pinch and burn sensation. This is from the numbing medicine that is put in the skin of your back. The epidural is put in through the numbed area. You may feel some pressure, but it should not hurt.

A small flexible catheter (tubing) is left in your back for the numbing medicine to go through to your epidural space. You will begin feeling numb in your stomach area, but not in your arms or legs. You will still feel touch, pressure and movement.