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Enhanced recovery after surgery (ERAS) and anesthesia

Year 2020, Volume: 4 Issue: 1, 95 - 101, 02.03.2020
https://doi.org/10.30565/medalanya.587027

Abstract

ERAS (Enhanced Recovery After Surgery) is a multimodal approach which aims to optimize perioperative management. ERAS is a combination of changes in preoperative, intraoperative and postoperative care to reduce organ dysfunction and surgical stress response. This concept is managed by multidisciplinary teams that include various areas of expertise to minimize the patient’s surgical stress response, optimize physiological functions, and facilitate healing. In order to further increase these developments in various surgical specialties, protocols have been established on this subject and many health institutions offer their services in this way. With the use of ERAS protocols, perioperative and postoperative complications decreased, patient survival and quality of care improved, and patient satisfaction was significantly increased.

References

  • 1. Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth. 1997;78(5):606-17. PMID: 9175983
  • 2. Kehlet H, Mogensen T. Hospital stay of 2 days after open sigmoidectomy with a multimodal rehabilitation programme. Br J Surg. 1999;86(2):227-30. PMID: 10100792
  • 3. Fearon KC, Ljungqvist O, Von Meyenfeldt M, Revhaug A, Dejong CH, Lassen K, et al. Enhanced recovery after surgery: a consensus review of clinical care for patients undergoing colonic resection. Clin Nutr. 2005;24(3):466-77. PMID: 15896435
  • 4. ERAS Türkiye Derneği. http://eras.org.tr/. Date of access:04.07.2019
  • 5. Ljungqvist O, Scott M, Fearon KC. Enhanced Recovery After Surgery: A Review. JAMA Surg. 2017;152(3):292-8. PMID: 28097305
  • 6. Gustafsson UO, Scott MJ, Schwenk W, Demartines N, Roulin D, Francis N, et al. Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS((R))) Society recommendations. World J Surg. 2013;37(2):259-84. PMID: 23052794
  • 7. Visioni A, Shah R, Gabriel E, Attwood K, Kukar M, Nurkin S. Enhanced Recovery After Surgery for Noncolorectal Surgery?: A Systematic Review and Meta-analysis of Major Abdominal Surgery. Ann Surg. 2018;267(1):57-65. PMID: 28437313
  • 8. Varadhan KK, Neal KR, Dejong CH, Fearon KC, Ljungqvist O, Lobo DN. The enhanced recovery after surgery (ERAS) pathway for patients undergoing major elective open colorectal surgery: a meta-analysis of randomized controlled trials. Clin Nutr. 2010;29(4):434-40. PMID: 20116145
  • 9. Horosz B, Nawrocka K, Malec-Milewska M. Anaesthetic perioperative management according to the ERAS protocol. Anaesthesiol Intensive Ther. 2016;48(1):49-54. PMID: 26966110
  • 10. Kahokehr A, Broadbent E, Wheeler BR, Sammour T, Hill AG. The effect of perioperative psychological intervention on fatigue after laparoscopic cholecystectomy: a randomized controlled trial. Surg Endosc. 2012;26(6):1730-6. PMID: 22258294
  • 11. Broadbent E, Kahokehr A, Booth RJ, Thomas J, Windsor JA, Buchanan CM, et al. A brief relaxation intervention reduces stress and improves surgical wound healing response: a randomised trial. Brain Behav Immun. 2012;26(2):212-7. PMID: 21741471
  • 12. Thomsen T, Villebro N, Moller AM. Interventions for preoperative smoking cessation. Cochrane Database Syst Rev. 2010(7):CD002294. PMID: 20614429
  • 13. Tonnesen H, Kehlet H. Preoperative alcoholism and postoperative morbidity. Br J Surg. 1999;86(7):869-74. PMID: 10417555
  • 14. Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures: An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology. 2017;126(3):376-93. PMID: 28045707
  • 15. Gustafsson UO, Nygren J, Thorell A, Soop M, Hellstrom PM, Ljungqvist O, et al. Pre-operative carbohydrate loading may be used in type 2 diabetes patients. Acta Anaesthesiol Scand. 2008;52(7):946-51. PMID: 18331374
  • 16. Breuer JP, von Dossow V, von Heymann C, Griesbach M, von Schickfus M, Mackh E, et al. Preoperative oral carbohydrate administration to ASA III-IV patients undergoing elective cardiac surgery. Anesth Analg. 2006;103(5):1099-108. PMID: 17056939
  • 17. Umari M, Falini S, Segat M, Zuliani M, Crisman M, Comuzzi L, et al. Anesthesia and fast-track in video-assisted thoracic surgery (VATS): from evidence to practice. J Thorac Dis. 2018;10(Suppl 4):S542-S54. PMID: 29629201
  • 18. Levy BF, Scott MJ, Fawcett WJ, Day A, Rockall TA. Optimizing patient outcomes in laparoscopic surgery. Colorectal Dis. 2011;13 Suppl 7:8-11. PMID: 22098510
  • 19. Block BM, Liu SS, Rowlingson AJ, Cowan AR, Cowan JA, Jr., Wu CL. Efficacy of postoperative epidural analgesia: a meta-analysis. JAMA. 2003;290(18):2455-63. PMID: 14612482
  • 20. Chiu C, Aleshi P, Esserman LJ, Inglis-Arkell C, Yap E, Whitlock EL, et al. Improved analgesia and reduced post-operative nausea and vomiting after implementation of an enhanced recovery after surgery (ERAS) pathway for total mastectomy. BMC Anesthesiol. 2018;18(1):41. PMID: 29661153
  • 21. Murphy GS, Szokol JW, Avram MJ, Greenberg SB, Marymont JH, Vender JS, et al. Intraoperative acceleromyography monitoring reduces symptoms of muscle weakness and improves quality of recovery in the early postoperative period. Anesthesiology. 2011;115(5):946-54. PMID: 21946094
  • 22. Nelson RL, Glenny AM, Song F. Antimicrobial prophylaxis for colorectal surgery. Cochrane Database Syst Rev. 2009(1):CD001181. PMID: 19160191
  • 23. Steinberg JP, Braun BI, Hellinger WC, Kusek L, Bozikis MR, Bush AJ, et al. Timing of antimicrobial prophylaxis and the risk of surgical site infections: results from the Trial to Reduce Antimicrobial Prophylaxis Errors. Ann Surg. 2009;250(1):10-6. PMID: 19561486
  • 24. Chatterjee S, Rudra A, Sengupta S. Current concepts in the management of postoperative nausea and vomiting. Anesthesiol Res Pract. 2011;2011:748031. PMID:22110499
  • 25. Gan TJ, Meyer TA, Apfel CC, Chung F, Davis PJ, Habib AS, et al. Society for Ambulatory Anesthesia guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2007;105(6):1615-28. PMID: 18042859
  • 26. Apfel CC, Kranke P, Eberhart LH, Roos A, Roewer N. Comparison of predictive models for postoperative nausea and vomiting. Br J Anaesth. 2002;88(2):234-40. PMID: 11883387
  • 27. Chandrakantan A, Glass PS. Multimodal therapies for postoperative nausea and vomiting, and pain. Br J Anaesth. 2011;107 Suppl 1:i27-40. PMID: 22156268
  • 28. Drover JW, Dhaliwal R, Weitzel L, Wischmeyer PE, Ochoa JB, Heyland DK. Perioperative use of arginine-supplemented diets: a systematic review of the evidence. J Am Coll Surg. 2011;212(3):385-99, 399.e1. PMID: 21247782
  • 29. Gundogdu RH. Current approach to perioperative nutrition in the ERAS age. Clin Sci Nutr. 2019;1(1):1-10. DOI: 10.5152/ClinSciNutr.2019.79
  • 30. Soop M, Carlson GL, Hopkinson J, Clarke S, Thorell A, Nygren J, et al. Randomized clinical trial of the effects of immediate enteral nutrition on metabolic responses to major colorectal surgery in an enhanced recovery protocol. Br J Surg. 2004;91(9):1138-45. PMID: 15449264
  • 31. Marimuthu K, Varadhan KK, Ljungqvist O, Lobo DN. A meta-analysis of the effect of combinations of immune modulating nutrients on outcome in patients undergoing major open gastrointestinal surgery. Ann Surg. 2012;255(6):1060-8. PMID: 22549749
  • 32. Dağıstanlı S, Uygar Kalaycı M, Kara Y. Evaluation of ERAS Protocol in General Surgery. İKSST Derg. 2018;10(Ek sayı):90-20. DOI:10.5222/iksst.2018.43043

Ameliyat Sonrası Geliştirilmiş İyileşme (ERAS) ve Anestezi

Year 2020, Volume: 4 Issue: 1, 95 - 101, 02.03.2020
https://doi.org/10.30565/medalanya.587027

Abstract

ERAS (Enhanced recovery after surgery) perioperatif yönetimi optimize etmeyi amaçlayan multimodal bir yaklaşımdır. ERAS, organ disfonksiyonunu ve cerrahi stres yanıtını azaltmak için preoperatif, intraoperatif ve postoperatif bakımdaki değişikliklerin bir bütünüdür. Bu kavram hastanın cerrahi stres yanıtını azaltmak, fizyolojik fonksiyonlarını düzeltmek ve iyileşmeyi kolaylaştırmak amacıyla çeşitli uzmanlık alanlarını içeren multidispliner ekipler tarafından yönetilir. Günümüzde değişik cerrahi uzmanlık alanlarında bu gelişmeleri daha da arttırmak amacıyla bu konu ile ilgili protokoller oluşturulmuş ve birçok sağlık kuruluşu hizmetlerini bu kavrama dayalı bir şekilde sunmaktadırlar. ERAS protokollerinin kullanımı ile periopetif ve postoperatif komplikasyonlarda azalma, hasta sağ kalımında ve bakım kalitesinde artış ve hasta memnuniyetinde belirgin gelişmeler sağlanmıştır.

References

  • 1. Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth. 1997;78(5):606-17. PMID: 9175983
  • 2. Kehlet H, Mogensen T. Hospital stay of 2 days after open sigmoidectomy with a multimodal rehabilitation programme. Br J Surg. 1999;86(2):227-30. PMID: 10100792
  • 3. Fearon KC, Ljungqvist O, Von Meyenfeldt M, Revhaug A, Dejong CH, Lassen K, et al. Enhanced recovery after surgery: a consensus review of clinical care for patients undergoing colonic resection. Clin Nutr. 2005;24(3):466-77. PMID: 15896435
  • 4. ERAS Türkiye Derneği. http://eras.org.tr/. Date of access:04.07.2019
  • 5. Ljungqvist O, Scott M, Fearon KC. Enhanced Recovery After Surgery: A Review. JAMA Surg. 2017;152(3):292-8. PMID: 28097305
  • 6. Gustafsson UO, Scott MJ, Schwenk W, Demartines N, Roulin D, Francis N, et al. Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS((R))) Society recommendations. World J Surg. 2013;37(2):259-84. PMID: 23052794
  • 7. Visioni A, Shah R, Gabriel E, Attwood K, Kukar M, Nurkin S. Enhanced Recovery After Surgery for Noncolorectal Surgery?: A Systematic Review and Meta-analysis of Major Abdominal Surgery. Ann Surg. 2018;267(1):57-65. PMID: 28437313
  • 8. Varadhan KK, Neal KR, Dejong CH, Fearon KC, Ljungqvist O, Lobo DN. The enhanced recovery after surgery (ERAS) pathway for patients undergoing major elective open colorectal surgery: a meta-analysis of randomized controlled trials. Clin Nutr. 2010;29(4):434-40. PMID: 20116145
  • 9. Horosz B, Nawrocka K, Malec-Milewska M. Anaesthetic perioperative management according to the ERAS protocol. Anaesthesiol Intensive Ther. 2016;48(1):49-54. PMID: 26966110
  • 10. Kahokehr A, Broadbent E, Wheeler BR, Sammour T, Hill AG. The effect of perioperative psychological intervention on fatigue after laparoscopic cholecystectomy: a randomized controlled trial. Surg Endosc. 2012;26(6):1730-6. PMID: 22258294
  • 11. Broadbent E, Kahokehr A, Booth RJ, Thomas J, Windsor JA, Buchanan CM, et al. A brief relaxation intervention reduces stress and improves surgical wound healing response: a randomised trial. Brain Behav Immun. 2012;26(2):212-7. PMID: 21741471
  • 12. Thomsen T, Villebro N, Moller AM. Interventions for preoperative smoking cessation. Cochrane Database Syst Rev. 2010(7):CD002294. PMID: 20614429
  • 13. Tonnesen H, Kehlet H. Preoperative alcoholism and postoperative morbidity. Br J Surg. 1999;86(7):869-74. PMID: 10417555
  • 14. Practice Guidelines for Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration: Application to Healthy Patients Undergoing Elective Procedures: An Updated Report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration. Anesthesiology. 2017;126(3):376-93. PMID: 28045707
  • 15. Gustafsson UO, Nygren J, Thorell A, Soop M, Hellstrom PM, Ljungqvist O, et al. Pre-operative carbohydrate loading may be used in type 2 diabetes patients. Acta Anaesthesiol Scand. 2008;52(7):946-51. PMID: 18331374
  • 16. Breuer JP, von Dossow V, von Heymann C, Griesbach M, von Schickfus M, Mackh E, et al. Preoperative oral carbohydrate administration to ASA III-IV patients undergoing elective cardiac surgery. Anesth Analg. 2006;103(5):1099-108. PMID: 17056939
  • 17. Umari M, Falini S, Segat M, Zuliani M, Crisman M, Comuzzi L, et al. Anesthesia and fast-track in video-assisted thoracic surgery (VATS): from evidence to practice. J Thorac Dis. 2018;10(Suppl 4):S542-S54. PMID: 29629201
  • 18. Levy BF, Scott MJ, Fawcett WJ, Day A, Rockall TA. Optimizing patient outcomes in laparoscopic surgery. Colorectal Dis. 2011;13 Suppl 7:8-11. PMID: 22098510
  • 19. Block BM, Liu SS, Rowlingson AJ, Cowan AR, Cowan JA, Jr., Wu CL. Efficacy of postoperative epidural analgesia: a meta-analysis. JAMA. 2003;290(18):2455-63. PMID: 14612482
  • 20. Chiu C, Aleshi P, Esserman LJ, Inglis-Arkell C, Yap E, Whitlock EL, et al. Improved analgesia and reduced post-operative nausea and vomiting after implementation of an enhanced recovery after surgery (ERAS) pathway for total mastectomy. BMC Anesthesiol. 2018;18(1):41. PMID: 29661153
  • 21. Murphy GS, Szokol JW, Avram MJ, Greenberg SB, Marymont JH, Vender JS, et al. Intraoperative acceleromyography monitoring reduces symptoms of muscle weakness and improves quality of recovery in the early postoperative period. Anesthesiology. 2011;115(5):946-54. PMID: 21946094
  • 22. Nelson RL, Glenny AM, Song F. Antimicrobial prophylaxis for colorectal surgery. Cochrane Database Syst Rev. 2009(1):CD001181. PMID: 19160191
  • 23. Steinberg JP, Braun BI, Hellinger WC, Kusek L, Bozikis MR, Bush AJ, et al. Timing of antimicrobial prophylaxis and the risk of surgical site infections: results from the Trial to Reduce Antimicrobial Prophylaxis Errors. Ann Surg. 2009;250(1):10-6. PMID: 19561486
  • 24. Chatterjee S, Rudra A, Sengupta S. Current concepts in the management of postoperative nausea and vomiting. Anesthesiol Res Pract. 2011;2011:748031. PMID:22110499
  • 25. Gan TJ, Meyer TA, Apfel CC, Chung F, Davis PJ, Habib AS, et al. Society for Ambulatory Anesthesia guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2007;105(6):1615-28. PMID: 18042859
  • 26. Apfel CC, Kranke P, Eberhart LH, Roos A, Roewer N. Comparison of predictive models for postoperative nausea and vomiting. Br J Anaesth. 2002;88(2):234-40. PMID: 11883387
  • 27. Chandrakantan A, Glass PS. Multimodal therapies for postoperative nausea and vomiting, and pain. Br J Anaesth. 2011;107 Suppl 1:i27-40. PMID: 22156268
  • 28. Drover JW, Dhaliwal R, Weitzel L, Wischmeyer PE, Ochoa JB, Heyland DK. Perioperative use of arginine-supplemented diets: a systematic review of the evidence. J Am Coll Surg. 2011;212(3):385-99, 399.e1. PMID: 21247782
  • 29. Gundogdu RH. Current approach to perioperative nutrition in the ERAS age. Clin Sci Nutr. 2019;1(1):1-10. DOI: 10.5152/ClinSciNutr.2019.79
  • 30. Soop M, Carlson GL, Hopkinson J, Clarke S, Thorell A, Nygren J, et al. Randomized clinical trial of the effects of immediate enteral nutrition on metabolic responses to major colorectal surgery in an enhanced recovery protocol. Br J Surg. 2004;91(9):1138-45. PMID: 15449264
  • 31. Marimuthu K, Varadhan KK, Ljungqvist O, Lobo DN. A meta-analysis of the effect of combinations of immune modulating nutrients on outcome in patients undergoing major open gastrointestinal surgery. Ann Surg. 2012;255(6):1060-8. PMID: 22549749
  • 32. Dağıstanlı S, Uygar Kalaycı M, Kara Y. Evaluation of ERAS Protocol in General Surgery. İKSST Derg. 2018;10(Ek sayı):90-20. DOI:10.5222/iksst.2018.43043
There are 32 citations in total.

Details

Primary Language English
Subjects Surgery
Journal Section Review
Authors

Filiz Alkaya Solmaz 0000-0001-5772-6708

Pakize Kırdemir 0000-0001-7784-1818

Publication Date March 2, 2020
Submission Date July 4, 2019
Acceptance Date October 14, 2019
Published in Issue Year 2020 Volume: 4 Issue: 1

Cite

Vancouver Alkaya Solmaz F, Kırdemir P. Enhanced recovery after surgery (ERAS) and anesthesia. Acta Med. Alanya. 2020;4(1):95-101.

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