Current Perioperative Management Strategies for Enhanced Recovery After Surgery

Enhanced recovery is a multimodal programme of multidisciplinary care designed to minimise post-operative organ dysfunction and return the patient to normality as soon as possible. The ERAS protocol composes of a lot of different interventions. This process is initially thought to be a radical move away from tradition and dogma to a fundamental change in the perioperative managements of patients and struggled to gain wider acceptance. The main philosophy of the ERAS protocol is to reduce the metabolic stress caused by surgical trauma and at the same time support the gastrointestinal functions and mobilization without complication. The key elements of the ERAS pathways are aimed to address these issues and the interventions that facilitate early recovery cover all phases of the perioperative period during the patients' journey. Several studies have demonstrated that the ERAS programmes compared with traditional perioperative care is associated with earlier recovery and discharge after major operations. The purpose of this review is to report on the current progress in the field of perioperative care, and show that using a combination of these factors has allowed evolution of programs of fast-track surgery leading to enhanced postoperative recovery.