Enhanced Recovery After Surgery (ERAS) Protocol | Norton Healthcare Louisville, Ky.

Enhanced Recovery After Surgery

The enhanced recovery after surgery (ERAS) protocol is a new approach to preparing for surgery and recovering that can help you heal faster, avoid complications and rely less on narcotic pain killers.

Part of the ERAS protocol is drinking nutritional supplements up to the day of your surgery. You’ll also start taking nonnarcotic pain medication to jump-start your pain control response.

Medical studies have shown that by taking certain steps before and after your surgery —  guided by a team of caregivers each with their own specialties — can help you return home faster and get back to the post-surgery life you’ve been hoping for.

Two Weeks Before Surgery

If you currently take a blood thinner, anti-platelet or anticoagulant medication, you must contact the prescribing provider and your surgeon for instructions on when to stop the medication before surgery. These medicines may include aspirin, Plavix (clopidogrel), Coumadin (warfarin), Eliquis (apixaban) or Xarelto (rivaroxaban).

Stop all decongestants, nasal sprays, Alka-Seltzer, Pepto Bismol, vitamins, diet pills and herbal supplements.

Seven Days Before Surgery

Stop taking nonsteroidal anti-inflammatory medications. This includes naproxen (Aleve), ibuprofen (Advil, Motrin), meloxicam (Mobic), diclofenac oral or gel, and celecoxib (Celebrex).

Five Days Before Surgery

If someone from pre-admission testing has not yet called you, call (502) 446-8660.

Start using Bactroban Nasal ointment (mupirocin) once in the morning and once at night. A prescription for this medication will be sent to your pharmacy ahead of your surgery date. Put a pea-size amount on a cotton swab and apply it to the inside of each nostril. (If redness, irritation, medication allergy or intolerance occurs, notify your surgeon and stop using the ointment.)

Four Days Before Surgery

Continue using Bactroban Nasal ointment (mupirocin), once in the morning and once at night.

Stop shaving on or around your surgical site.

Shower with chlorhexidine gluconate (CHG) soap using a clean washcloth. Wash with your regular soap first and then with the CHG, leaving the CHG on your skin for one minute before rinsing with warm water. Pat dry with a clean towel. Keep the CHG soap out of your eyes, ears, nose and mouth, and away from your genital area. Stop using CHG if you have an allergic reaction. If this happens, switch to an antibacterial soap, such as Dial. Dry yourself with a clean towel.

Three Days Before Surgery

Continue using Bactroban Nasal ointment (mupirocin), once in the morning and once at night.

Shower with CHG using a clean washcloth. Dry yourself with a clean towel.

Two Days Before Surgery

Continue using Bactroban Nasal ointment (mupirocin), once in the morning and once at night.

Shower with CHG cleanser using a clean washcloth. Dry yourself with a clean towel.

One Day Before Surgery

Finish using Bactroban Nasal ointment (mupirocin), once in the morning and once at night.

Shower with CHG using a clean washcloth. Dry yourself with a clean towel.

Put on clean pajamas and sleep on clean sheets.

Follow your medication instructions.

Remove all jewelry (including wedding rings), and leave them at home.

  • 8 p.m.: Drink one pre-surgery nutrition drink.
  • 10 p.m.: Drink one pre-surgery nutrition drink.
  • Bedtime: Take 1,000 milligrams of acetaminophen (Tylenol).
  • Do not eat after midnight.
  • Do not smoke or use tobacco after midnight.

Day of Surgery

Follow your medication instructions as discussed with your pre-admission testing nurse.

Two hours before your scheduled surgery time, drink your last pre-surgery nutrition drink.

Do not drink anything within two hours before your surgery time, including water and coffee.

Shower with CHG right before leaving for the hospital, using a clean washcloth and drying off with a clean towel.

Do not use mascara, makeup, lotion, powder, perfume, deodorant or after-shave.

Bring your continuous positive airway pressure (CPAP) machine, inhalers, glasses (no contacts), dentures and hearing aids, if you use them.

Bring a picture ID, your insurance card and copayment, if you have one.

Care That’s Focused on You

  • Minimally invasive procedures can have you home quickly with less pain and faster recovery.
  • Sophisticated pain management aims to keep you comfortable and safe.
  • We have a deep commitment to getting you moving again and managing your pain so you can keep up with your physical therapy.
  • With 30 orthopedic locations in Louisville, Southern Indiana and surrounding communities, we have specialists near you.
  • Communicate with your provider, manage appointments, refill prescriptions and more, anytime, from a computer or mobile device with a free MyNortonChart account.

About Norton Orthopedic Institute

More patients choose Norton Orthopedic Institute for hip or knee replacements and other orthopedic procedures than any other health care provider in Louisville, Kentucky, or in Southern Indiana.

  • We have more than 50 providers, including board-certified and fellowship-trained orthopedic surgeons at 30 locations in Louisville and Southern Indiana.
  • We offer same-day appointments.
  • Norton Orthopedic Institute and Norton Leatherman Spine have received DNV Healthcare’s Orthopaedic Center of Excellence certification, recognizing the highest level of competence for treating orthopedic conditions.
  • Norton Orthopedic Institute’s hip and knee replacement program also has been recognized by DNV as a center of excellence, meeting guidelines of the American College of Orthopaedic Surgeons and the American Association of Hip and Knee Surgeons.
  • Our hip replacement specialists are pioneers in minimally invasive surgeries focused on minimizing pain and recovery time.
  • State-of-the-art minimally invasive surgical techniques improve precision for a more natural-feeling knee replacement to get you moving again.
  • Participate in online seminars from home to learn what to expect before, during and after a hip or knee replacement.
Ortho 502-559-5500

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