Perioperative management according to the principles of the program of rapid postoperative recovery (ERAS) in the prevention of acute bowel obstruction (a clinical lecture)

The article presents the main directions for the prevention of acute bowel obstruction in patients after surgery. The basis of prevention is the principle of rapid postoperative recovery accor­ding to the widely used ERAS program (Enhanced Recovery after Surgery). The basic principles of the ERAS program correspond to three periods: preoperative, intraoperative and postoperative. In the pre­operative period, much attention is paid to the preparation of a patient and the correction of conditions that may lead to prolonged recovery after surgery (eg, anaemia, etc). Intraoperatively, it is re­commended to apply combined principles of anaesthesia to reduce the use of opiates and anaesthetics, based on regional and local me­thods of anaesthesia. At this stage, thorough monitoring is important to prevent intraoperative hypo- and hypervolemia. Early activation of patients plays a key role in the postoperative period. Therefore, proper analgesia, prevention of nausea and vomiting will also lead to early mobilization and early enteral nutrition of the patients.