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Enhanced recovery after thoracic anesthesia.

Mert Senturk1, Zerrin Sungur1

  • 1Department of Anesthesiology and Reanimation, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.

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Summary

Enhanced Recovery After Surgery (ERAS) protocols for thoracic surgery (ERATS) are evolving. This review discusses debatable elements in current ERATS guidelines to inform future evidence-based improvements.

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Area of Science:

  • Anesthesiology
  • Thoracic Surgery
  • Perioperative Medicine

Background:

  • Enhanced Recovery After Surgery (ERAS) is a sophisticated perioperative approach that has expanded from colorectal to thoracic surgery.
  • ERAS protocols for thoracic surgery (ERATS) are established, with anesthesiology being a key component.
  • Existing ERATS guidelines face challenges due to limited evidence on overall recovery outcomes and poor reporting of adherence.

Purpose of the Study:

  • To analyze and discuss debatable aspects of the 2019 ERATS protocols.
  • To identify areas requiring further research for a more evidence-based ERATS protocol.
  • To provide a framework for future advancements in enhanced recovery after thoracic surgery.

Main Methods:

  • Review and critical discussion of the official ERATS protocols from a joint consensus.
  • Analysis of existing literature on thoracic anesthesia and ERATS outcomes.
  • Identification of challenges in protocol adherence and implementation.

Main Results:

  • Significant gaps exist in studies evaluating the overall outcome and quality of recovery in ERATS.
  • Many components of current ERATS protocols lack sufficient evidence and are considered debatable.
  • Poor reporting and practical difficulties hinder the adherence and compliance with ERATS elements.

Conclusions:

  • Further research is needed to strengthen the evidence base for ERATS components.
  • Addressing the challenges in adherence and implementation is crucial for effective ERATS.
  • Future efforts should focus on developing a more robust and evidence-based ERATS protocol for thoracic surgery.