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Guidelines on perioperative optimization protocol for the adult patient 2023
Sébastien Bloc1, Pascal Alfonsi2, Anissa Belbachir3
1Clinical Research Department, Ambroise Pare Hospital Group, Neuilly-sur-Seine, France; Department of Anesthesiology, Clinique Drouot Sport, Paris, France.
Anaesthesia, Critical Care & Pain Medicine
|June 9, 2023
Summary
This study provides 30 expert recommendations for perioperative optimization programs, enhancing patient care across surgical fields. These guidelines, developed independently, focus on pre-, intra-, and postoperative measures for improved outcomes.
Area of Science:
- Anesthesiology and Intensive Care Medicine
- Surgical Patient Care
Background:
- Guidelines for perioperative optimization programs were developed by the French Society of Anesthesiology and Intensive Care Medicine (SFAR).
- A consensus committee of 29 experts convened, adhering to a strict conflict-of-interest policy and independent of industry funding.
- The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system guided the quality assessment of evidence.
Framework:
- Recommendations structured into four fields: Generalities, Preoperative, Intraoperative, and Postoperative measures.
- Questions formulated using the PICO model (population, intervention, comparison, outcomes).
- Extensive bibliographic searches conducted following PRISMA guidelines and analyzed using GRADE methodology.
Implementation:
- Recommendations formulated using the GRADE methodology and voted on by experts.
- Formalized expert recommendations format adopted due to extensive GRADE application.
- Consensus reached on 30 recommendations, with 19 of high evidence (GRADE 1±) and 10 of low evidence (GRADE 2±).
Implications:
- Provides a comprehensive framework for implementing perioperative optimization programs.
- Aims to standardize and improve patient care throughout the surgical journey.
- Offers evidence-based guidance for anesthesiologists and intensive care specialists.
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