A new recovery program for abdominal surgery patients at University of Virginia Health System is helping patients go home sooner while making them more comfortable both before and after surgery.
Abdominal surgery patients typically need at least five to six days of recovery time before heading home from the hospital, said UVA colorectal surgeon Traci Hedrick, MD. One reason for the recovery time is that many patients develop an ileus - a condition that affects the patient's bowels and makes it difficult to eat. "If you can't eat, you can't be discharged from the hospital," said UVA anesthesiologist Bob Thiele, MD.
Two main causes of an ileus, Thiele said, are giving patients powerful pain medications known as opioids and large amounts of intravenous (IV) fluid following their surgery. The IV fluid can cause swelling and make it harder for patients to move around following surgery.
An Enhanced Recovery Program
UVA's team took several steps to improve the recovery process:
•To reduce the need for IV fluid, UVA abdominal surgery patients are allowed to have sports drinks up to two hours before their surgery and immediately following surgery.
•Opioid pain medications have largely been replaced with non-narcotic medications such as acetaminophen.
•Patients are required to get out of bed and move around. Patients need to be out of bed for six hours on the first day following surgery and eight hours on the second day.
The recovery program takes a team effort from across the Health System, including UVA anesthesiologists, colorectal surgeons, the pre-admission testing center and nurses who care for the patients before, during and after surgery.
"Our staff is really enthusiastic about the program," Hedrick said. "We're asking them to do more, such as getting patient out of bed in the recovery room, but they're happy to do it because it helps the patients."