Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 1: pathophysiological considerations

被引：277

作者：

Scott, M. J. ^{[1
]}

Baldini, G. ^{[2
]}

Fearon, K. C. H. ^{[3
]}

Feldheiser, A. ^{[4
]}

Feldman, L. S. ^{[5
]}

Gan, T. J. ^{[6
]}

Ljungqvist, O. ^{[7
]}

Lobo, D. N. ^{[8
]}

Rockall, T. A. ^{[1
]}

Schricker, T. ^{[9
]}

Carli, F. ^{[2
]}

机构：

[1] Univ Surrey, Royal Surrey Cty Hosp NHS Fdn Trust, Guildford GU2 5XH, Surrey, England

[2] McGill Univ, Ctr Hlth, Dept Anesthesia, Montreal Gen Hosp, Montreal, PQ H3G 1A4, Canada

[3] Univ Edinburgh, Royal Infirm, Surg Clin, Edinburgh EH3 9YW, Midlothian, Scotland

[4] Charite, Mitte & Campus Virchow Klinikum, Dept Anesthesiol & Intens Care Med Campus Charit, D-13353 Berlin, Germany

[5] McGill Univ, Ctr Hlth, Montreal Gen Hosp, Dept Surg, Montreal, PQ H3G 1A4, Canada

[6] Duke Univ, Med Ctr, Dept Anesthesiol, Durham, NY 27710 USA

[7] Univ Orebro, Fac Med & Hlth, Dept Surg, SE-70182 Orebro, Sweden

[8] Univ Nottingham Hosp, Queens Med Ctr, Div Gastrointestinal Surg, Biomed Res Unit,Natl Inst Hlth Res,Nottingham Dig, Nottingham NG7 2UH, England

[9] McGill Univ, Royal Victoria Hosp, Ctr Hlth, Dept Anesthesia, Montreal, PQ H3A 1A1, Canada

来源：

ACTA ANAESTHESIOLOGICA SCANDINAVICA | 2015年 / 59卷 / 10期

关键词：

PREOPERATIVE ORAL CARBOHYDRATE; RANDOMIZED CLINICAL-TRIAL; POSTOPERATIVE COGNITIVE DYSFUNCTION; MAJOR ABDOMINAL-SURGERY; COLORECTAL SURGERY; INSULIN-RESISTANCE; PERIOPERATIVE CARE; EPIDURAL ANALGESIA; FLUID THERAPY; REGIONAL ANESTHESIA;

D O I：

10.1111/aas.12601

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

BackgroundThe present article has been written to convey concepts of anaesthetic care within the context of an Enhanced Recovery After Surgery (ERAS) programme, thus aligning the practice of anaesthesia with the care delivered by the surgical team before, during and after surgery. MethodsThe physiological principles supporting the implementation of the ERAS programmes in patients undergoing major abdominal procedures are reviewed using an updated literature search and discussed by a multidisciplinary group composed of anaesthesiologists and surgeons with the aim to improve perioperative care. ResultsThe pathophysiology of some key perioperative elements disturbing the homoeostatic mechanisms such as insulin resistance, ileus and pain is here discussed. ConclusionsEvidence-based strategies aimed at controlling the disruption of homoeostasis need to be evaluated in the context of ERAS programmes. Anaesthesiologists could, therefore, play a crucial role in facilitating the recovery process.

引用

页码：1212 / 1231

页数：20

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