Advice after your nerve block for surgery
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What is enhanced recovery?
Enhanced recovery is a way of improving your experience and wellbeing following major surgery. It helps you recover sooner, with the aim of getting you back to your normal life as quickly as possible. You will play an active part in your recovery post-operatively, along with the different specialists that will be caring for you.
There are four main stages:
- Planning and preparation before admission. This will include information about improving nutrition and physical fitness.
- Reducing the physical stress of the operation.
- Guidance on pain relief.
- Guidance on early mobilisation, eating, and drinking following your operation.
Before your operation
Before your operation, it is really important for you to try and make yourself as fit as possible.
- If you smoke, it is ideal to give up smoking as soon as you can.
- If you drink alcohol, it is ideal to give up drinking for a month before your operation.
- It is also useful to increase your exercise to improve your overall fitness. If you would like information about our pre-habilitation service, please contact the Clinical Nurse Specialist team, who will be able to advise further.
- If you have lost weight, we recommend that you increase your calorie intake.
Boosting your nutritional intake
If you have lost weight recently, need to gain weight, or are struggling with a poor appetite, these 3 steps might help:
Step 1: Eat ‘little and often'
- Aim to eat six small meals or snacks throughout the day.
- Choose full-fat dairy products and avoid foods labelled as diet','reduced/low-fat' or ‘healthy eating’ at this time.
- Eat what you fancy; if your appetite is better at certain times in the day, eat more.
- Drinking fluids during a meal can make you feel full, so try to wait until after a meal or snack to have a drink.
Step 2: Fortify your foods
to make every mouthful more nourishing by adding small amounts of high-calorie foods without increasing the portion size.
- Add double or single cream to potatoes (boiled, mashed, or jacketed), porridge, puddings, sauces, soups, fruit (fresh, tinned, or stewed), hot milky drinks, smoothies, and milkshakes.
- Add butter and/or cheese to potatoes (boiled, mashed, or jacketed), crackers, crumpets, sandwiches, toast, and vegetables.
- Add oil to pasta and salad dressings, and use it for frying.
- Add full-fat mayonnaise to potatoes (boiled, mashed, or fried), sandwiches, and salad dressings.
- Add peanut butter to crumpets, toast, sandwiches, smoothies, and milkshakes (avoid if you are concerned about nut allergies).
- Add jam or honey to crumpets, toast, scones, porridge, and rice pudding.
Step 3: Have nourishing drinks between meals
instead of water or squash, as these are still hydrating but will give you extra protein and calories. (Aim for 2 drinks per day.)
Nourishing drink ideas
Hot milky drinks
Add the following to 140 ml of warm whole (full cream) milk:
- 1 heaped tablespoon of skimmed milk powder
- 2 tablespoons of double cream or
- 2 heaped teaspoons of coffee granules, hot chocolate powder, or malt drink powder, e.g., HorlicksTM, OvaltineTM
Milkshakes
Add the following to 140 ml of cold (full cream) milk:
- 1 heaped tablespoon of skimmed milk powder
- 2 tablespoons of double cream
- 2 heaped teaspoons of milkshake powder, e.g., Nesquik™ or 2 tablespoons of milkshake syrup, e.g., CrushTM
Make your own fortified milk. Mix 4 heaped tablespoons of skimmed milk powder, e.g., Marvel™ or your shop’s own brand, into 1 pint of whole (full cream) milk. Once made up, keep it in the fridge to use during the day whenever you would normally have milk, e.g., on its own, in hot and cold drinks, on porridge or cereal, and for making puddings, e.g., custard or instant desserts.
Try shop-bought milkshakes or smoothies.
Over-the-counter supplements, milkshakes, and soups are available from most supermarkets and chemists without a prescription.
Improving your fitness
In the weeks before your operation, you should increase your movement. Aim to spend more time on your feet. That can be through formal exercise or by doing more walking, even by increasing the number of times you go up and down the stairs per day. Ideally, you should be doing something that makes you breathe harder, but you should still be able to hold a conversation.
Prehabilitation exercise video
How much?
- You should be aiming to complete 20 or 30 minutes of physical movement five times per week.
How hard?
- This can be anything that makes you feel short of breath, even if this is simply walking at a brisk pace; everyone’s limit will be different. It should increase your level of breathing, but you should still be able to talk.
Why?
- Evidence shows exercising regularly can improve recovery and lessen the risk of complications after surgery.
Immediately after your operation, we would like you to start taking deeper breaths.
Deep breathing exercises
- Take three deep breaths every half hour.
- Breathe deeply through your nose, hold for 2-3 seconds, then slowly breathe out of your mouth.
Coughing
- Support your tummy with a folded towel or pillow and apply overpressure; this will make it more comfortable.
If it is too painful to cough or take a deep breath, please ask the nursing team for more pain relief.
Coming for pre-assessment
Before your surgery, you will receive an appointment to meet with the pre-assessment team. This may include an appointment to see an anaesthetist.
During this appointment, you may require a blood test and other tests.
Please allow at least 2 hours for this appointment.
Other tests that you may require prior to your operation, outside of pre-assessment, may include:
CPEX: This is a cardiopulmonary exercise test that involves pedalling a static exercise bike against increasing resistance. This appointment may last about 40–60 minutes.
Echocardiogram: This is a scan that is used to look at the heart and nearby blood vessels. This will help the anaesthetist see if you require any adjustments with medications prior to your surgery.
Lung function test: lung function tests (also called pulmonary function tests) include a variety of tests that check how well the lungs work. The most basic test is spirometry. This test measures the amount of air the lungs can hold. The test also measures how forcefully one can empty air from the lungs.
**Please note: It is important to bring a list of your regular medications to your pre-assessment appointment.
Stoma care
During your consultation, your surgeon will discuss with you whether your type of surgery will result in the formation of a permanent or temporary stoma. It may be that they hope to avoid a stoma, but at the time of your surgery, they may decide that the safest option is to create a stoma. This information will be given to you prior to signing the consent form.
If the stoma is made from an opening in the colon, it is called a colostomy. If it is made from an opening in the small bowel (ileum), it is called an ileostomy.
Temporary stomas are formed to allow your bowels time to heal after surgery. This is usually followed by a second surgery a few months later to close the stoma; this type of surgery is called a stoma reversal.
If your surgeon feels you may need a stoma during surgery, you will be invited to attend 1 or 2 appointments with the Stoma Team prior to your planned surgery date.
During these appointments, the stoma team will give you information about living with a stoma, teach you how to care for a stoma, and show you how to change a stoma pouch. This will help you become independent in looking after your stoma following your operation. You will be provided with an information pack that includes pouches for you to practice with at home before the surgery date.
Prior to your surgery, a stoma nurse will put a mark on the front of your tummy (with a permanent marker pen), which will help the surgeon decide the best place for the stoma to be sited. It is best to attend your appointment with the stoma nurse wearing clothing that you regularly wear so that your clothing and waistband can be considered during the sitting process.
After surgery, if a stoma has been formed, a stoma nurse will visit and change your stoma pouch on the first working day after surgery. The stoma nurse will provide all the supplies that you will need to care for your stoma and leave a stock of them with you. A member of the stoma team will visit at least once a day (Monday–Friday) to teach you how to care for your stoma. A member of the ward staff will support you with your stoma needs when a stoma nurse is not available until you are independent.
You (or a family member) will need to be independent with your stoma care before you can be discharged home.
Once discharged, you will continue to have follow-up appointments in the clinic with the stoma nurses.
Mobility after surgery on ward
Day 1 – you can mobilise to your chair and please walk up to 4 times a day around 60 metres each time. You can start eating and drinking. Analgesia will be provided to stop PCA.
Day 2 – please walk up to 4 times a day , 60 meters each time. You can have a full diet. You may be able to be discharged if passing flatus.
Day 3 – You should be discharged today once passing flatus
Useful contact numbers
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Colorectal Clinical Nurse Specialist (CNS) (Wexham Park and Frimley Park) |
Cancer navigator number: 0300 613 3535 |
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Wexham Park Hospital CNS Team |
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Stoma Care Nurses |
Telephone Number: 0300 615 3734 Email: fhft. |
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Alcohol Specialist Nurse WPH |
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Frimley Park Hospital CNS Team |
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Stoma Care Nurses |
Telephone Number: 0300 613 6301 Email: fhft. |
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Alcohol Specialist Nurse FPH |
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Stop Smoking Nurse |
Hilary Naudi 0300 613 6246 |
Useful Links
Contact us
If you have any queries relating to this information, please contact the General surgery service.
About this information
Service:
General surgery
Reference:
HH/047
Approval date:
1 March 2026
Review date:
1 March 2029
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.