Anaesthesia

Anaesthesia

Enhanced recovery pathways have become the established standard of care in many different areas of surgery.

Anaesthetists play a unique and vital role in the success of ERAS programmes in every speciality.

Fluid therapy and analgesia are two key areas of focus.

Individualised goal-directed fluid therapy has received a large amount of attention and whilst generated some controversy, there is no doubt that extremes of fluid balance will ultimately reduce tissue oxygen delivery either by poor cardiac output (too little fluid) or by oedema (excess fluid).

The key areas for analgesia are effective multimodal, opioid-sparing analgesia. The routine use of epidurals for these patients is increasingly debated.

The guideline linked below is a consensus paper, published in 2016.

It includes several recommendations to enhance recovery in patients undergoing gastrointestinal surgery. (Many of which can be applied to ERAS programs for all specialities)

Preoperatively: optimisation of medical disease and cessation of smoking and alcohol intake are emphasized.

Prevention of nausea and vomiting is an important element.

Careful titration of anaesthesia and ensuring full recovery of neuromuscular blockade are recommended.

The guideline also includes recommendations regarding fluid therapy, opioid-sparing analgesia and mobilisation.

Expert Reviews

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Contacts

Webinar Editor

Professor William Fawcett (UK)

Professor Bill Fawcett is a Consultant in Anaesthesia and Pain Medicine, Royal Surrey County Hospital Guildford, UK. and is currently Vice President of The Association of Anaesthetists of Great…

Website Editor

Dr Chris Jones (UK)

Chris has been a Consultant Anaesthetist at the Royal Surrey County Hospital and St Luke’s Cancer Centre in Guildford, UK, since 2013. His training in anaesthesia was based at…