Fast-Track Surgery.ppt


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Fast-TrackSurgeryMaggieGordon,R2October2,2007Fast-TrackSurgeryWhatisfast-tracksurgery?esKehletH,:630,onceptPre-oppatienteducationNewtechniques:anaesthetic,analgesic,surgicalReduce:stress,pain,fortAggressivepost-riteriaastraditionalcareKehletH,,ACSSurgery:Principles&PracticeGoalsLowerrisk,plications(pulmonary,cardiac,thromboembolic,infectious)ShortenconvalescenceKehletH,,ACSSurgery:Principles&PracticeLiteratureSearchWebofScienceTopic=fasttrackANDcolon*2002-presentEnglisharticlesandreviewsFound35articlesaboutcolonsurgeryavailablefromMcMasterlibrary3reviews1consensusstatementfoundincitationsFast-TrackSurgeryWhatshouldwedopre-operatively?PatientEducationTellpatientswhattoexpectImprovespatientcollaborationwithteamanxietyanalgesianeedsTellpatientstheirroleinrecoveryOptimizepatientsmedicallyIncludingsmoking,EtOHcessationKehletH,:630,2002FearonKC,:466,2005NoPre-OpBowelPrepBowelprep→anastomoticdehiscence(mendationsnotclearyetforlowanteriorresections)WindJ,:800,2006SoopM,:166,2006LimitedFastingSolidsuntil6hoursbeforesurgeryClearfluidsuntil2hoursbeforesurgerySafeBeneficialCarbohydrate-loadedliquidpre-oppost-opcatabolisminsulinresistance,hyperglycemiamusclelossWindJ,:800,2006SoopM,:166,2006FearonKC,:466,2005

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