Enhanced recovery after surgery in ambulatory procedures

Area of Science:

• Anesthesiology
• Perioperative Medicine
• Surgical Recovery

Background:

• The rise in ambulatory surgeries necessitates efficient, safe, and patient-centered perioperative care.
• Enhanced Recovery After Surgery (ERAS) principles provide a structured approach to optimize ambulatory surgical pathways.
• This review focuses on recent advancements in managing patients undergoing outpatient procedures.

Purpose of the Study:

• To review current evidence and advancements in perioperative management for ambulatory surgery.
• To highlight the role of ERAS principles in streamlining ambulatory care.
• To discuss new anesthetic agents and strategies within ERAS protocols.

Main Methods:

• Literature review of recent evidence on ambulatory anesthesia and ERAS.
• Analysis of new anesthetic agents and adjuncts for opioid-sparing analgesia.
• Evaluation of advancements in monitoring, antiemetic strategies, and recovery metrics.

Main Results:

• Newer hypnotics like remimazolam and ciprofol demonstrate favorable safety profiles.
• Adjunct anesthetics such as low-dose ketamine, dexmedetomidine, and methadone show potential for opioid reduction.
• Innovations include Bispectral index-guided systems, improved antiemetic protocols, and patient-centered discharge criteria.

Conclusions:

• ERAS protocols are recommended for ambulatory anesthesia, with anesthesiologists playing a key role.
• Further research is needed on novel agents within ERAS, standardized outcome measures, and real-time audit tools.
• Optimizing ambulatory care requires continued investigation into advanced anesthetic and recovery strategies.