Table 1 Components of enhanced recovery in spinal surgery, grouped according to perioperative stage of care.
| Preadmission period | Intraoperative period | Postoperative period |
|---|---|---|
| 1. Preadmission information, education and counseling | 9. Prevention of nausea and vomiting | 17. Thromboprophylaxis |
| 2. Risk assessment, preoperative optimization, including lifestyle factor modification |
10. Surgical site preparation and antimicrobial prophylaxis 10.1 Surgical site preparation 10.2 Antimicrobial prophylaxis | 18. Urinary drainage |
| 2.1 Pre-operative risk stratification | 11. Local anaesthetic infiltration | 19. Postoperative nutrition and fluid management |
| 2.2 Preoperative assessment and optimization | 12. Standard anaesthetic protocol | 20. Postoperative glycemic control |
| 2.3 Alcohol use | 13.Surgical access (open and minimally invasive spinal surgery, including robotic surgery) | 21. Early mobilization |
| 2.4 Tobacco use | 14. Maintenance of normothermia | Quality of care measures |
| 3. Prehabilitation | 15. Intraoperative fluid and electrolyte therapy | 22. Audit |
| 4. Preoperative nutritional care | 16. Perioperative analgesia | |
| 4.1 Nutritional assessment and screening | ||
| 4.2 Perioperative immuno-nutrition | ||
| 5. Management of anaemia | ||
| 6. Perioperative blood conservation strategies | ||
| Preoperative period | ||
| 7.Preoperative fasting and carbohydrate loading | ||
| 8.Preemptive analgesia |