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Enhanced Recovery Protocol

USC Colorectal SurgeonsThere are many benefits to enhanced recovery:

Here at USC, we have a cutting edge program designed to help you get better faster. It involves a combination of improved pain control, early walking and activity after surgery, and starting a diet on the evening of surgery or the next day. Only about 30% of hospitals use enhanced recovery programs, but studies have shown it can decrease the time you spend in the hospital by 1-2 days. This means you are back at home with your family faster, and on the road to recovery. Use of this type of protocol has also been shown to decrease complication rates by up to 50%. Ask your surgeon about it today for more information.



Pathway Component


Preoperative medications:

  1. To speed recovery of intestines: Alvimopan (Entereg)
  2. To prevent blood clots: heparin, leg squeezers
  3. To control pain pre-emptively: Tylenol, gabapentin
  4. To prevent infections: chlorhexidine soap/shower and wipes on skin

Postoperative multimodal pain control:

  1. Local anesthetic infused during surgery
  2. Scheduled acetaminophen, gabapentin, ibuprofen
    (not just as needed)
  3. Narcotic pills as needed for breakthrough pain
  4. IV medications if still have pain (these often are not needed with the scheduled use of other medications and have the side effect of slowing down the intestine and delaying recovery).

Diet (we try and minimize prolonged periods of fasting)

  1. Liquid diet until just before you arrive at the hospital for surgery
    (if instructed by your anesthesia doctor during START visit/call)
  2. Begin liquid diet on evening of surgery
  3. Eat regular food starting the day after surgery if no nausea

Walking (this has many benefits to speed recovery)

  1. Evening of surgery: out of bed for > 2 hours
  2. Day 1 after surgery: out of bed for > 8 hrs (3 or more walks + up in chair)



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Appointments (323) 865-3690


USC Colorectal Surgery
1450 San Pablo Street
Healthcare Consultation Center 4
Suite 6200
Los Angeles, CA 90089

Phone: (323) 865-3690
Fax: (323) 865-3671

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