Enhanced Recovery After Surgery (ERAS) - Nephrectomy - 18 Weeks

Preparing for SurgeryThe day before surgery you will be able to eat and drink as normal, you will also be givenhigh carbohydrate drinks. These are an essential part of your care and help boost yourenergy prior to surgery. You will be given instructions on how and when to take these.Once you are in hospital, you will be given a blood thinning injection, to help reduceyour risk of blood clots.What Happens To Me When I Arrive At The Ward?You will be admitted on the day of surgery. We will ask that you administer an enema onthe evening prior to your admission. This will help clear you bowels in preparation forthe operation.On the Day of the ProcedureYou will be admitted on the day of surgery. A nurse will check you in, detail yournormal medications and supply you with special stockings to prevent leg clots. Beforegoing to the operating theatre, you will be asked to change into a theatre gown. Anymake-up, nail varnish, jewellery (except your wedding ring), and contact lenses must beremoved. You will be seen by an anaesthetist who will discuss your anaesthetic as wellas make recommendations about how to manage any pain after the procedure. You willbe consented by your surgeon and after a number of checks have a mark drawn on yourabdomen to confirm the side of operation.You will have nothing to eat or drink for about 2hrs before your operation but will beadvised in more detail when you attend for your pre-op assessment.Your operation will take about 4-5 hours and is performed under general anaesthetic (youare completely asleep during all of this time).What Happens After The Procedure?A bed will be booked for you either in ward B31 or the High Dependency Unit (HDU) orintensive care unit (ICU) where your condition can be monitored closely. This is oftennecessary after major surgery, as you will have spent a long time under anaesthetic. Youwill spend 24 to 72 hours before returning to the ward.To reduce pain after the operation you will be given regular painkillers. The anaesthetistwill have discussed this with you and will have decided on either:• A pain killer device that you control releases painkillers into your blood streamthrough a drip. This is called Patient Controlled Analgesia (PCA).• An epidural - pain killers and local anaesthetic are given directly into the spinalnerve system. This involves inserting a very fine tube into your back at the time ofyou operation through which these drugs are given.Final 4 October 2012