ERAS vs Conventional Approach in Peptic Perforation-RCT

"* Tracheal intubation and with General anesthesia~* Short acting anesthetic agents,avoid opioid agents~* Omental patch repair with placement of sub hepatic drain~* Bilateral Transverse abdominis plane block/ Rectus sheath block immediately after surgery.~* Post operative nausea and vomiting prophylaxis.~* Encourage to mobilize out of bed after effect of general anesthesia has weaned off.~* Initiation of feeding-Oral sips on day 1, step up day 2 onward~* Removal of nasogastric tube-immediately after surgery after aspirating the gastric content through nasogastric tube.~* Removal of urinary catheter-after weaning from the effect of general anesthesia.~* Sub hepatic drain removal -anytime within 24 hours;drain will not be removed if fluid is bilious or pus.~* Avoid opiod analgesics."

"Tracheal intubation~* Short acting anesthetic agents, avoid opiod anesthesia agents.~* Omental patch repair along with sub hepatic drain placement.~* Post operative nausea and vomiting prophylaxis.~* Ambulation-as per patients' own request.~* Initiation of oral feed- after passage of 1st flatus.~* Nasogastric tube removal-output \<300ml/day with resolution of ileus.~* Removal of urinary catheter- when patient sits on bed side/ambulate.~* Removal of sub hepatic drain-when patient tolerates unrestricted amount of liquid diet and drain output is less than 200 ml /day.~* Patient will receive opiod analgesics."