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Enhanced Recovery Programs in Outpatient Surgery.

Anoushka M Afonso1, Hanae K Tokita2, Patrick J McCormick3

  • 1Enhanced Recovery Programs (ERP), Department of Anesthesiology & Critical Care Medicine, Josie Robertson Surgery Center, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, M-301, New York, NY 10065, USA.

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Enhanced recovery pathways are effective in ambulatory surgery. Focus should be on quality of recovery, pain management, and early ambulation, not length of stay.

Keywords:
Ambulatory surgeryEnhanced recovery after surgeryEnhanced recovery programsMultimodal analgesiaOpioid-sparing pain managementPeripheral nerve blocksPostdischarge nausea and vomitingQuality of recovery

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Area of Science:

  • Surgical recovery protocols
  • Ambulatory surgery optimization

Background:

  • Enhanced recovery pathways (ERPs) initially focused on inpatients.
  • Ambulatory surgery requires adapted ERP principles for success.

Purpose of the Study:

  • To highlight the relevance of ERP principles in the ambulatory setting.
  • To define key metrics for ambulatory ERP success.

Main Methods:

  • Implementing multimodal analgesia for pain and nausea.
  • Utilizing regional anesthesia techniques.
  • Providing robust preoperative education.

Main Results:

  • Opioid minimization is crucial for ambulatory ERPs.
  • Quality of recovery is a primary outcome measure.
  • Early ambulation is a key indicator of success.

Conclusions:

  • Ambulatory ERPs require a shift in focus from length of stay.
  • Effective pain and nausea management are vital.
  • Patient education is integral to successful ambulatory recovery.