(Adapted from Kehlet H, Wilmore DW. Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg 2008; 248:189–198, with permission)
Perioperative Elements Contributing to Enhanced Recovery After Surgery (ERAS)
(Adapted from Fearon KC, Ljungqvist O, Von Meyenfeldt M, et al. Enhanced recovery after surgery: a consensus review of clinical care for patients undergoing colonic resection. Clin Nutr 2005; 24:466–477, with permission)
Anesthetic Elements Contributing to Enhanced Recovery Program
Preoperative Period
• Patient education
• Preoperative risk assessment and optimization
• Smoking and alcohol cessation
• Minimizing preoperative fasting and dehydration
Intraoperative Period
• Antithrombotic prophylaxis
• Antibiotic prophylaxis
• Strategies to minimize the stress response to surgery
° Minimally invasive surgery
° Regional anesthesia techniques
° Intravenous (IV) local anesthetic
° IV β-blockers
° IV α2-agonist