Enhanced Recovery After Surgery

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.

This volume presents a comprehensive, up to date and practical approach to creating an ERAS program for GI surgery. The first sections review the evidence underlying individual elements of ERAS, including evidence from laparoscopic procedures when available or pointing to evidence gaps where more research is required. These are written by experts in the field, including surgeons, anesthesiologists, nurses, and physiotherapists. The format is in the style of a narrative review, with narrative evidence review, and concluding with a table with “take home messages” and 3-5 key references for readers interested in more depth in each topic. Each chapter also addresses management of common complications and patient selection or exceptions. Subsequent chapters address practical concerns, including creation of a pathway team, project management and engaging administration. Experts contribute real-world examples of their pathways for a variety of procedures, including colorectal surgery, bariatric surgery, upper GI and hepatobiliary surgery, enabling the user to have a starting point for creating their own programs. The SAGES Manual of Enhanced Recovery Programs for Gastrointestinal Surgery will be of great value to fully trained surgeons, anesthesiologists, nurses and administrators interested in initiating an ERAS program.

Practical resource for all healthcare professionals involved in day-to-day management of operating rooms of all sizes and complexity.

Manual of Fast Track Recovery for Colorectal Surgery provides a broad overview on enhanced recovery, with expert opinions from leaders in the field regarding elements of enhanced recovery care that are generic and specific to colorectal surgery. This book covers the patient journey through such a programme, commencing with optimisation of the patient’s condition, patient education and conditioning of their expectations. Manual of Fast Track Recovery for Colorectal Surgery investigates the metabolic response to surgery, anaesthetic contributions and optimal fluid management, after surgery. It also details examples of enhanced recovery pathways and practical tips on post-operative pain control, feeding, mobilisation and criteria for discharge. Manual of Fast Track Recovery for Colorectal Surgery is a valuable reference tool for colorectal surgeons, anaesthetists, ward nurses and other members of the team involved in perioperative care: pain control specialists, physiotherapists, dietitians, specialist therapists (such as colorectal and stoma nurses), and outpatient nurses.

Medical knowledge about blood, its use in transfusions, and blood products has grown exponentially, as well as awareness about its safety, risks and costs. In a discipline where risks are proportional to benefits, medical specialists involved in open heart surgery need to have the latest information to make informed decisions. Dr. Attar's work reflects the contributors' direct interest and experience in blood and cardiac surgery introducing the latest information on blood and its use, hemostasis, blood conservation techniques and safety, the risks involved, alternatives to blood transfusions, the diagnosis and therapy of coagulopathy associated with cardiac surgery, and medicolegal aspects. Medical advances include the latest intraoperative diagnostic measures for platelet functions and therapy strategies for hemostasis abnormalities with cardiac surgery. This work is unique for its extensive and critical description of instruments and tests used intraoperatively, especially for the evaluation of the coagulation factors and platelets, the algorithms for transfusion guidelines and the detailed application of APROTININ and other antifibrinolytic agents in minimizing bleeding in cardiac surgery. Written for cardiac and transplant specialists -- from surgeons, anesthesiologists, surgical nurses to perfusionists -- this valuable and timely reference thoroughly explores the subject of blood transfusions in open heart surgery, its clinical applications, the current status of blood substitutes and important legal aspects.

The approach to total hip and total knee arthroplasty is changing around the world. There is now a strong emphasis on a more rapid recovery and on more outpatient surgery. Each step of the process is now being modified with more thorough pre-operative evaluations, streamlined surgical approaches, rapid mobilization and faster return to normal activities. These changes place new pressures on all of the health care providers in the system. This unique text - the first of its kind - is a practical guide for each member of the clinical team with updates by the leading authorities from around the country. Each chapter addresses a specific issue and will outline the important new items that need to be addressed, very similar to a handbook. Topics covered include the implementation of new payment models and outcome measurements, recommendations to streamline the pre-, peri- and post-operative protocols, the utility and application of outpatient joint replacement programs, multimodal pain management and post-acute rehabilitation strategies. There is no publication at present that addresses all of these items together in one convenient place. Rapid Recovery in Total Joint Arthroplasty is written and edited by experienced clinicians and surgeons, sharing their years of experience to create a practical, up-to-date text useful for everyday work.

Written by experts at the top-ranked Hospital for Special Surgery in New York, Perioperative Care of the Orthopedic Patient is a comprehensive, multidisciplinary manual providing preoperative considerations, postoperative complications, and guidelines for the anesthetic and medical management of patients undergoing orthopedic surgery. Beginning with chapters covering preoperative evaluations and general principles and practices of perioperative medicine, the book then considers anesthesiologic management in orthopedic surgery and the role of postoperative pain management. This is followed by a section on medical management in specific clinical settings, discussing patients with connective tissue disease, cardiac disease, chronic pulmonary and renal diseases, diabetes and psychiatric and neurological diseases. A fourth section covers specific perioperative problems in orthopedic surgery, such as care of the elderly patient, venous thromboembolism, infection, nutrition, compartment syndrome, and bone health. Finally, the role of allied services, quality improvement and ethics are highlighted, and selected case studies are included to illustrate real-world perioperative issues and management strategies in orthopedic surgery. A comprehensive yet concise reference, Perioperative Care of the Orthopedic Patient will be an invaluable resource for orthopedic surgeons, sports medicine specialists and any professional involved in orthopedic surgery.

"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"--

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.

As innovations are constantly being developed within health care, it can be difficult both to select appropriate new practices and technologies and to successfully adopt them within complex organizations. It is necessary to understand the consequences of introducing change, how to best implement new procedures and techniques, how to evaluate success and to improve the quality of patient care. This comprehensive guide allows you to do just that. Improving Patient Care, 2nd edition provides a structure for professionals and change agents to implement better practices in health care. It helps health professionals, managers, policy makers and researchers to assess new techniques and select and implement change in their organizations. This new edition includes recent evidence and further coverage on patient safety and patient centred strategies for change. Written by an international expert author team, Improving Patient Care is an established standard text for postgraduate students of health policy, health services and health management. The strong author team are global professors involved in managing research and development in the field of quality improvement, evidence-based practice and guidelines, quality assessment and indicators to improve patient outcomes through receiving appropriate healthcare.