Opportunities and Challenges for the Next Phase of Enhanced Recovery After Surgery: A Review

Opportunities and Challenges for the Next Phase of Enhanced Recovery After Surgery : A Review

Ljungqvist, Olle, 1954- (author): Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Department of Surgery

de Boer, Hans D. (author): Department of Anaesthesiology, Pain Medicine and Procedural Sedation and Analgesia, Martini General Hospital Groningen, Groningen, the Netherlands

Balfour, Angie (author): Surgical Services, NHS [National Health Service] Lothian, Edinburgh, United Kingdom

Fawcett, William J. (author): Department of Anaesthesia and Pain Medicine, Royal Surrey County Hospital NHS Foundation Trust, Guildford, United Kingdom

Lobo, Dileep N. (author): Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom; MRC (Medical Research Council) Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Nottingham School of Life Sciences, Queen's Medical Centre, Nottingham, United Kingdom

Nelson, Gregg (author): Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Obstetrics and Gynecology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

Scott, Michael J. (author): Anesthesiology and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia

Wainwright, Thomas W. (author): Orthopaedic Research Institute, Bournemouth University, Bournemouth, United Kingdom; Physiotherapy Department, University Hospitals Dorset NHS Foundation Trust, Bournemouth, United Kingdom

Demartines, Nicolas (author): Department of Visceral Surgery, University Hospital Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland

(creator_code:org_t)

2021-04-21
2021
English.
In: JAMA Surgery. - : American Medical Association. - 2168-6254 .- 2168-6262. ; 56:8, s. 775-784

Related links:: https://urn.kb.se/re...; show more...; https://doi.org/10.1...; http://kipublication...; show less...

Abstract Subject headings

Importance: Enhanced Recovery After Surgery (ERAS) is a global surgical quality improvement initiative now firmly entrenched within the field of perioperative care. Although ERAS is associated with significant clinical outcome improvements and cost savings in numerous surgical specialties, several opportunities and challenges deserve further discussion.Observations: Uptake and implementation of ERAS Society guidelines, together with ERAS-related research, have increased exponentially since the inception of the ERAS movement. Opportunities to further improve patient outcomes include addressing frailty, optimizing nutrition, prehabilitation, correcting preoperative anemia, and improving uptake of ERAS worldwide, including in low- and middle-income countries. Challenges facing enhanced recovery today include implementation, carbohydrate loading, reversal of neuromuscular blockade, and bowel preparation. The COVID-19 pandemic poses both a challenge and an opportunity for ERAS.Conclusions and Relevance: To date, ERAS has achieved significant benefit for patients and health systems; however, improvements are still needed, particularly in the areas of patient optimization and systematic implementation. During this time of global crisis, the ERAS method of delivering care is required to take surgery and anesthesia to the next level and bring improvements in outcomes to both patients and health systems.

By the author/editor: Ljungqvist, Olle ...; de Boer, Hans D.; Balfour, Angie; Fawcett, William ...; Lobo, Dileep N.; Nelson, Gregg; show more...; Scott, Michael J ...; Wainwright, Thom ...; Demartines, Nico ...; show less...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

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