Amir Elhassan1, Ihab Elhassan1, Amjad Elhassan2, Krish D Sekar3, Ryan E Rubin3, Richard D Urman4, Elyse M Cornett5, Alan David Kaye3. 1. Department of Anesthesiology, Ohio State University School of Medicine, Columbus, OH, USA. 2. University of North Carolina, Chapel Hill, NC, USA. 3. Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA. 4. Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA. 5. Department of Anesthesiology, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA. ecorne@lsuhsc.edu.
Abstract
PURPOSE OF REVIEW: Enhanced recovery pathways provide a framework outlining the best perioperative care for intra-abdominal surgical procedures. To date, no evidence-based umbrella guidelines exist for all intra-abdominal surgeries. RECENT FINDINGS: A PubMed and worldwide web search was performed with the keywords: "ERAS," "enhanced recovery after surgery", ± "protocol." Manuscripts addressing intra-abdominal procedures were selected, resulting in studies with the date range: 2012-2017. The basic philosophy behind enhanced recovery is the realization that a traditional hospital works in silos that need to be broken to ensure a care protocol that follows and optimizes the journey the patient makes during the perioperative care. Enhanced recovery interventions can be categorized into preoperative, perioperative, and postoperative interventions. By design, each intervention is planned and coordinated by a multidisciplinary ERAS team. Depending on the particular procedure and patient receiving the interventions, some of the interventions below may be more or less applicable. In this review, the most common elements of ERAS protocols in intra-abdominal procedures are reviewed, particularly those which provided the best outcomes and are most generalizable to all intra-abdominal procedures.
PURPOSE OF REVIEW: Enhanced recovery pathways provide a framework outlining the best perioperative care for intra-abdominal surgical procedures. To date, no evidence-based umbrella guidelines exist for all intra-abdominal surgeries. RECENT FINDINGS: A PubMed and worldwide web search was performed with the keywords: "ERAS," "enhanced recovery after surgery", ± "protocol." Manuscripts addressing intra-abdominal procedures were selected, resulting in studies with the date range: 2012-2017. The basic philosophy behind enhanced recovery is the realization that a traditional hospital works in silos that need to be broken to ensure a care protocol that follows and optimizes the journey the patient makes during the perioperative care. Enhanced recovery interventions can be categorized into preoperative, perioperative, and postoperative interventions. By design, each intervention is planned and coordinated by a multidisciplinary ERAS team. Depending on the particular procedure and patient receiving the interventions, some of the interventions below may be more or less applicable. In this review, the most common elements of ERAS protocols in intra-abdominal procedures are reviewed, particularly those which provided the best outcomes and are most generalizable to all intra-abdominal procedures.
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