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  1. Home
  3. Rica Pathway (enhanced Recovery After Surgery For Adults). 2026 Update: Executive Summary.
  1. Home
  3. Rica Pathway (enhanced Recovery After Surgery For Adults). 2026 Update: Executive Summary.

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Published on: December 30, 2025

RICA Pathway (Enhanced Recovery After Surgery for Adults). 2026 Update: Executive Summary.

J M Ramírez-Rodríguez1, P M Ruiz-López2, J M Estrada-Lorenzo3

  • 1Coordinador general del Proyecto, Grupo Español de Rehabilitación Multimodal (GERM), Departamento de Cirugía. Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain.

Revista Espanola De Anestesiologia Y Reanimacion
|June 27, 2026

View abstract on PubMed

Summary
This summary is machine-generated.

The RICA Pathway project updates guidelines for Enhanced Recovery After Surgery in adults. New recommendations focus on evidence-based practices for elective major surgery, improving patient care.

Keywords:
Adult surgeryAtención perioperatoriaCirugía del adultoClinical pathwayEnhanced recovery after surgeryEvidence-based medicineMedicina basada en la evidenciaPerioperative careRecuperación intensificada en cirugíaVías clínicas

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Published on: December 30, 2025

Area of Science:

  • Perioperative Medicine
  • Surgical Outcomes Research

Background:

  • The RICA Pathway (Enhanced Recovery After Surgery in Adults) aims to provide updated, evidence-based recommendations for perioperative care.
  • Continuous updates are crucial to reflect the latest scientific evidence and improve surgical outcomes.

Purpose of the Study:

  • To maintain updated and consensual recommendations for Enhanced Recovery After Surgery in adults based on rigorous scientific evidence.
  • To facilitate the implementation and evaluation of these evidence-based guidelines for elective major surgery.

Main Methods:

  • Systematic reviews of evidence using the GRADE methodology across major databases (PubMed, Embase, Cochrane Library).
  • Inclusion of diverse study types: systematic reviews, meta-analyses, RCTs, guidelines, and multicenter studies.
  • Recommendations developed and approved by consensus through a structured project group.

    • Main Results:

    • 106 recommendations approved, a reduction from 135 in the 2021 edition, indicating refinement.
    • High or moderate evidence supported 83% of the recommendations.
    • A strong grade of recommendation was in favor for 76% of the updated guidelines.
    • Recommendations are now grouped into "bundles" for enhanced applicability.

    Conclusions:

    • The updated RICA Pathway provides a refined set of evidence-based recommendations for Enhanced Recovery After Surgery.
    • The project emphasizes high-quality evidence and strong recommendations to optimize perioperative care for adults undergoing elective major surgery.
    • Grouping recommendations into bundles aims to improve practical implementation and clinical impact.