Anesthesia management for ambulatory surgery under the concept of enhanced recovery after surgery_West China Medical Journal

Authors：

GAO Zunzheng , FENG Yan ,  SUN Defeng

Department of Anesthesiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116011, P. R. China;

Corresponding?author：

SUN Defeng, Email: sdf-yl@163.com

Keywords：

Enhanced recovery after surgery; ambulatory surgery; perioperative period; pain management; postoperative nausea and vomiting

DOI：

10.7507/1002-0179.202211071

Video：

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Enhanced recovery after surgery (ERAS) is a protocol designed to improve perioperative outcomes by multidisciplinary team with evidence-based interventions. The implementation of ERAS concept has been proved to reduce postoperative complications and hospital stay. The anesthesia management under the concept of ERAS is the basis of safe and smooth ambulatory surgical protocol. This article summarizes the latest clinical evidence at home and abroad, and reviews the preoperative optimization, anesthesia mode selection, ventilation strategies, fluid management, temperature support, pain management, postoperative nausea and vomiting prevention, postoperative nutritional support, and postoperative sleep improvement in the management of anesthesia under ERAS concept, in order to provide a reference for anesthesia management in ambulatory surgery.

Citation： GAO Zunzheng, FENG Yan, SUN Defeng. Anesthesia management for ambulatory surgery under the concept of enhanced recovery after surgery. West China Medical Journal, 2023, 38(2): 170-179. doi: 10.7507/1002-0179.202211071 Copy

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1. Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth, 1997, 78(5): 606-617.
2. Zhang X, Yang J, Chen X, et al. Enhanced recovery after surgery on multiple clinical outcomes: umbrella review of systematic reviews and meta-analyses. Medicine (Baltimore), 2020, 99(29): e20983.
3. 國家衛生健康委辦公廳. 國家衛生健康委辦公廳關于印發日間手術推薦目錄(2022 年版)的通知. (2022-02-25)[2022-11-09]. http://www.nhc.gov.cn/yzygj/s3594q/202202/f57ca70b23f34ca88308979ef19bde4b.shtml.
4. 朱宏, 黃鴻燕, 鄭胄斌, 等. 日間手術的經濟學評價研究綜述. 衛生經濟研究, 2021, 38(9): 25-28, 32.
5. Joshi GP. Enhanced recovery pathways for ambulatory surgery. Curr Opin Anaesthesiol, 2020, 33(6): 711-717.
6. 中華醫學會麻醉學分會“成人日間手術加速康復外科麻醉管理專家共識”工作小組. 成人日間手術加速康復外科麻醉管理專家共識. 協和醫學雜志, 2019, 10(6): 562-569.
7. Edwards R, Gibson J, Mungin-Jenkins E, et al. A Preoperative spinal education intervention for spinal fusion surgery designed using the rehabilitation treatment specification system is safe and could reduce hospital length of stay, normalize expectations, and reduce anxiety: a prospective cohort study. Bone Jt Open, 2022, 3(2): 135-144.
8. Grant MC, Pio Roda CM, Canner JK, et al. The impact of anesthesia-influenced process measure compliance on length of stay: results from an enhanced recovery after surgery for colorectal surgery cohort. Anesth Analg, 2019, 128(1): 68-74.
9. Jalilian L, Wu I, Ing J, et al. Evaluation of telemedicine use for anesthesiology pain division: retrospective, observational case series study. JMIR Perioper Med, 2022, 5(1): e33926.
10. Kamdar NV, Huverserian A, Jalilian L, et al. Development, implementation, and evaluation of a telemedicine preoperative evaluation initiative at a major academic medical center. Anesth Analg, 2020, 131(6): 1647-1656.
11. Chen W, Wu Q, Fu N, et al. Patient selection for ambulatory laparoscopic cholecystectomy: a systematic review. J Minim Access Surg, 2022, 18(2): 176-180.
12. 李俊杰, 馮艷, 孫德峰. 日間手術麻醉新進展. 華西醫學, 2022, 37(2): 295-300.
13. Joshi GP, Ahmad S, Riad W, et al. Selection of obese patients undergoing ambulatory surgery: a systematic review of the literature. Anesth Analg, 2013, 117(5): 1082-1091.
14. Szeto B, Vertosick EA, Ruiz K, et al. Outcomes and safety among patients with obstructive sleep apnea undergoing cancer surgery procedures in a freestanding ambulatory surgical facility. Anesth Analg, 2019, 129(2): 360-368.
15. Bailey CR, Ahuja M, Bartholomew K, et al. Guidelines for day-case surgery 2019: guidelines from the Association of Anaesthetists and the British Association of Day Surgery. Anaesthesia, 2019, 74(6): 778-792.
16. Pattnaik S, Dixit SK, Bishnoi V. The burden of surgical cancellations: a quality improvement study on the importance of preoperative assessment. Cureus, 2022, 14(1): e21731.
17. Lee JY, Kim HT, Choi JH, et al. Effect of clinical anesthesia preoperative evaluation on the length of preoperative period and total hospitalization of patients undergoing laparoscopic cholecystectomy. Am J Transl Res, 2021, 13(10): 11943-11947.
18. Gillis C, Ljungqvist O, Carli F. Prehabilitation, enhanced recovery after surgery, or both? A narrative review. Br J Anaesth, 2022, 128(3): 434-448.
19. Gillis C, Buhler K, Bresee L, et al. Effects of nutritional prehabilitation, with and without exercise, on outcomes of patients who undergo colorectal surgery: a systematic review and meta-analysis. Gastroenterology, 2018, 155(2): 391-410.e4.
20. Barberan-Garcia A, Ubré M, Roca J, et al. Personalised prehabilitation in high-risk patients undergoing elective major abdominal surgery: a randomized blinded controlled trial. Ann Surg, 2018, 267(1): 50-56.
21. McIsaac DI, Gill M, Boland L, et al. Prehabilitation knowledge network. Prehabilitation in adult patients undergoing surgery: an umbrella review of systematic reviews. Br J Anaesth, 2022, 128(2): 244-257.
22. Badiani S, Diab J, Woodford E, et al. Impact of preoperative smoking on patients undergoing right hemicolectomies for colon cancer. Langenbecks Arch Surg, 2022, 407(5): 2001-2009.
23. Heiden BT, Eaton DB Jr, Chang SH, et al. Assessment of duration of smoking cessation prior to surgical treatment of non-small cell lung cancer. Ann Surg, 2021, 18: 10.
24. Iqbal U, Green JB, Patel S, et al. Preoperative patient preparation in enhanced recovery pathways. J Anaesthesiol Clin Pharmacol, 2019, 35(Suppl 1): S14-S23.
25. Kaka AS, Zhao S, Ozer E, et al. Comparison of clinical outcomes following head and neck surgery among patients who contract to abstain from alcohol vs patients who abuse alcohol. JAMA Otolaryngol Head Neck Surg, 2017, 143(12): 1181-1186.
26. 中華醫學會外科學分會, 中華醫學會麻醉學分會. 中國加速康復外科臨床實踐指南(2021)(一). 協和醫學雜志, 2021, 12(5): 624-631.
27. Gupta R, Gan TJ. Peri-operative fluid management to enhance recovery. Anaesthesia, 2016, 71(Suppl 1): 40-45.
28. McCracken GC, Montgomery J. Postoperative nausea and vomiting after unrestricted clear fluids before day surgery: a retrospective analysis. Eur J Anaesthesiol, 2018, 35(5): 337-342.
29. Perlas A, Mitsakakis N, Liu L, et al. Validation of a mathematical model for ultrasound assessment of gastric volume by gastroscopic examination. Anesth Analg, 2013, 116(2): 357-363.
30. Spencer AO, Walker AM, Yeung AK, et al. Ultrasound assessment of gastric volume in the fasted pediatric patient undergoing upper gastrointestinal endoscopy: development of a predictive model using endoscopically suctioned volumes. Paediatr Anaesth, 2015, 25(3): 301-308.
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West China Medical Journal

Anesthesia management for ambulatory surgery under the concept of enhanced recovery after surgery

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