A 55-year-old patient after major abdominal surgery is being assessed for nutritional support. Which of the following best reflects the current evidence from the ERAS (Enhanced Recovery After Surgery) protocol regarding perioperative nutrition?

• A Early enteral nutrition should be started within 24 hours of surgery; preoperative carbohydrate loading is recommended up to 2 hours before anesthesia ✓
• B Patients should be kept nil by mouth for 5-7 days postoperatively
• C Total parenteral nutrition is preferred over enteral nutrition in the postoperative period
• D Nasogastric tubes should be routinely left in place for 5 days to ensure gut decompression

Explanation

ERAS protocols represent a paradigm shift in perioperative care. Key nutritional elements include: preoperative carbohydrate loading (12.5% carbohydrate drink up to 2 hours before anesthesia reduces insulin resistance and anxiety, shortened fasting periods); early oral intake or enteral nutrition within 24 hours of surgery is recommended and associated with reduced complications and shorter hospital stay; routine nasogastric tubes should be avoided. Enteral nutrition is preferred over parenteral nutrition whenever the gut is functional. These measures collectively reduce the surgical stress response and improve outcomes.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.