Research Article

Fast Track Liver Resection: The Effect of a Comprehensive Care Package and Analgesia with Single Dose Intrathecal Morphine with Gabapentin or Continuous Epidural Analgesia

Table 2

Nursing care plan for patients managed with continuous epidural analgesia.

Day of SurgeryAdmit to surgical ward
Normal medications continued (excluding anticoagulants)
Nil by mouth 4 hours before surgery
Below knee TED stockings fitted
Liquid/light diet ad libertum on waking
Vital signs monitoring postoperatively including hourly respiratory rate for 24 hours

Postoperative Day 1Check full blood count, electrolytes, liver function, INR
Remove arterial line and calf compression device
Central venous line maintenance fluids
Unrestricted diet ad libertum
Normal medications
Mobilize as able

Postoperative Day 2Check full blood count, electrolytes, liver function, INR
Central venous line maintenance fluids
Unrestricted diet ad libertum
Mobilize as able

Postoperative Day 3Check full blood count, electrolytes, liver function, INR
Central venous line maintenance fluids
First surgical dressing change
Stop epidural and remove catheter
Remove urinary catheter
Unrestricted diet ad libertum
Mobilize as able

Postoperative Day 4Check full blood count, electrolytes, liver function, INR
Unrestricted diet ad libertum
Mobilize as able

Postoperative Day 5Check full blood count, electrolytes, liver function, INR
Unrestricted diet ad libertum
Remove central venous line
Mobilize as able

Postoperative Day 6Unrestricted diet ad libertum
Remove central venous line
Mobilize as able
Review discharge criteria

Postoperative Day 7Unrestricted diet ad libertum
Remove central venous line
Mobilize as able
Discharge