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Enhanced Recovery for Major Abdominopelvic Surgery is a clinical manual providing detailed, expert guidance on the various components of the enhanced recovery program for major abdominopelvic surgery. Several chapters of the handbook are devoted to overcoming the challenges of implementing an enhanced recovery protocol within a practice or institution. Specific protocols for the most common abdominopelvic surgeries, including colorectal, liver, major gyn, distal pancreas and Whipple¿s, and cystectomy are presented. Evidence supporting the protocol is included in each chapter as appropriate. The handbook is targeted to surgeons, anesthesiologists, nurses, and hospital administrators.
This book is the first comprehensive, authoritative reference that provides a broad and comprehensive overview of Enhanced Recovery After Surgery (ERAS). Written by experts in the field, chapters analyze elements of care that are both generic and specific to various surgeries. It covers the patient journey through such a program, commencing with optimization of the patient’s condition, patient education, and conditioning of their expectations. Organized into nine parts, this book discusses metabolic responses to surgery, anaesthetic contributions, and optimal fluid management after surgery. Chapters are supplemented with examples of ERAS pathways and practical tips on post-operative pain control, feeding, mobilization, and criteria for discharge. Enhanced Recovery After Surgery: A Complete Guide to Optimizing Outcomes is an indispensable manual that thoroughly explores common post-operative barriers and challenges.
Practical resource for all healthcare professionals involved in day-to-day management of operating rooms of all sizes and complexity.
This issue of Surgical Clinics of North America focuses on Enhanced Recovery After Surgery: Past, Present, and Future, and is edited by Dr. Daniel I. Chu. Articles will include: Overview of Enhanced Recovery After Surgery: The Evolution and Adoption of ERAS in North America; ERAS and Effects on Quality Metrics; ERAS and Effects on Patient-Reported Outcomes; ERAS: Economic Impact and Value; Pre-Op Preparations for ERAS: A Role for Prehabilitation; ERAS and Multimodal Strategies for Analgesia; ERAS and Intra-operative Fluid Strategies; ERAS Implementation: Strategies, Barriers and Facilitators; Nursing Perspectives on ERAS; ERAS and Reduction of Surgical Disparities; ERAS in Community Hospitals; ERAS: What's New in Colorectal; ERAS: Hepatobiliary; ERAS: Urology; ERAS: Gyn-Oncology; ERAS and Future Directions; and more!
This book presents current evidence in an Enhanced Recovery Programme context, and provides a common sense approach to using the array of available analgesia techniques appropriately in major abdominal surgery. Current pain relief options are discussed, many of which have been described only in the last ten years. Topics covered range from the now widespread use of portable ultrasound machines to an appreciation of the value of some older drugs in a new context. Analgesia for Major Abdominal Surgery is aimed at anesthetists, acute pain teams, and acute pain nurses, as well as colorectal, hepatobiliary, urological and gynecological surgeons.
This revised and expanded second edition presents the most recent evidence-based facts on perioperative fluid management and discusses fluid management from basic sciences to clinical applications and the patients’ outcomes. Recent advances in understanding the Revised Starling principle with new concepts in tissue perfusion and the most recent techniques of perioperative goal directed fluid management are described. The endothelial glycocalyx functions and the influence of fluid management on its integrity are covered in detail; moreover, the techniques for its protection are also discussed. The dilemma of perioperative use of hydroxyethyl starch solutions and the resurgence of interest in using human albumin as an alternative colloid is explored. The problems of using unbuffered solutions during the perioperative period and comparison between restrictive versus liberal fluid management are discussed in full. Lastly, case scenarios for every possible clinical situation describe the most up-to-date fluid management for the corresponding clinical problem. Perioperative Fluid Management, Second Edition is of interest to anesthesiologists and also intensivists.
"Enhanced recovery after surgery (ERAS) programs are a multidisciplinary approach in the perioperative care of the patient undergoing major surgery, including pre, intra and postoperative measures, based on the actual evidence published in literature (evidence-based medicine), to improve the postoperative recovery of the patient. ERAS protocols have been widely developed in colorectal surgery, but, given their excellent results, new protocols and guidelines have been developed in other surgical fields, including abdominal and extra-abdominal areas. In the last decade, several ERAS protocols have been implemented worldwide in bariatric surgery, confirming their safety and advantages of ERAS approaches, even on morbidly obese patients. The aim of this book is to update the actual evidence about ERAS protocols on bariatric surgery, analyzing separately the different components and multidisciplinary approach of the ERAS programs"--
There is a growing need for a book on emergency general surgery in the elderly, as adults age 65 and older are the fastest growing segment of the population worldwide, and their number is expected to double to 89 million between now and 2050. Based on these changing demographics, it is expected that there will be a concurrent rise in the demand for a variety of surgical services, including vascular surgery (with a projected growth of 31%) and general surgery (with a projected growth of 18%), as well as in all sub-disciplines of surgery (thoracic, cardiac, oncology, hepatobiliary, transplant, plastic colorectal, orthopedic, gynecologic, urology and neurosurgery).In addition, older surgical patients often require a different level of care than younger patients during the preoperative, intraoperative and postoperative phases. Many of our geriatric population have multiple chronic illnesses beyond the one for which surgery is required, and therefore are prone to developing postoperative complications, functional decline, loss of independence, and other undesirable outcomes. In response, this book offers surgeons, geriatrists and nurses state-of-the-art surgical approaches and essential information on the complex perioperative care of the elderly.
Recovering from surgery is greatly dependent upon the type of surgery you will be having. Enhanced recovery pathways include preoperative, intraoperative, and postoperative practices that decrease complications and accelerate recovery. How long it takes you to fully recover from your surgery will depend on many things, including: • your age • your health before the surgery • the extent of your injuries • the success of your rehabilitation • the amount of rest you get. It may take a few days or a week to recover from a less complex operation, but it can take a few months to recover from major surgery. The American Society of Anesthesiologists Physical Status (ASA-PS) classification has long been used as a ranking system that quantifies patient health before anesthesia and surgery. It is widely used to determine a patient’s likelihood of developing postoperative complications. ERAS is the acronym of Enhanced Recovery After Surgery: a multimodal perioperative approach based on the best medical evidence. The aim of this program is to try to change the physiological and psychological responses to major surgery. Malnutrition is one of the most important patient-related factors affecting morbidity and mortality in surgical patients. In addition, infections are important in the recovery process after surgery.