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Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 2: consensus statement for anaesthesia

A Feldheiser1, O Aziz2, G Baldini3

  • 1Department of Anesthesiology and Intensive Care Medicine Campus Charité, Mitte and Campus Virchow-Klinikum Charité, University Medicine, Berlin, Germany.

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This review provides anesthesia recommendations for gastrointestinal surgery patients in Enhanced Recovery After Surgery (ERAS) programs. Anesthesiologists play a key role in optimizing preoperative, intraoperative, and postoperative ERAS elements for better patient outcomes.

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Area of Science:

  • Anesthesiology
  • Surgical Care

Background:

  • Consensus review on anesthetic practice for gastrointestinal surgery patients within Enhanced Recovery After Surgery (ERAS) programs.
  • Highlights the interdisciplinary approach to optimizing patient care pathways.

Purpose of the Study:

  • To propose clinical considerations and recommendations for anesthetic practice in ERAS programs for gastrointestinal surgery.
  • To unify protocols and facilitate anesthesiologist involvement in ERAS implementation.

Main Methods:

  • Systematic review of English-language literature, prioritizing meta-analyses, RCTs, and large prospective cohort studies.
  • Critical appraisal of available evidence for each perioperative treatment pathway element.
  • Consensus reached by experts after literature review.

Main Results:

  • Anesthesiologists significantly influence preoperative, intraoperative, and postoperative ERAS elements.
  • Demonstrates the anesthesiologist's control over key aspects of ERAS protocols.
  • Identifies areas where further research is needed to strengthen recommendations.

Conclusions:

  • Presents comprehensive recommendations for anesthesia care in ERAS gastrointestinal surgery based on current evidence.
  • Aims to standardize anesthetic contributions to ERAS programs for improved consistency and comparison.
  • Facilitates multi-institutional research and trial design for ERAS optimization.