Fast-track surgery: Toward comprehensive peri-operative care

Nanavati, Aditya; Prabhakar, S.

doi:10.4103/0259-1162.134474

Cited by 57 publications

(41 citation statements)

References 46 publications

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“…; Story and Chamberlain ). In human patients, this approach has been shown to reduce the prevalence of POI, duration of hospitalisation, readmission rates, morbidity and pain (Story and Chamberlain ; Nanavati and Prabhakar ), and to preserve cell‐mediated immunity (Wichmann et al . ).…”

Section: Post‐operative Feedingmentioning

confidence: 99%

Post‐operative reflux – a surgeon's perspective

Freeman

2017

Equine Veterinary Education

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Summary Post‐operative ileus (POI) is a well‐recognised complication of colic surgery that accounts for a high proportion of post‐operative deaths. Although much has been written about the pathophysiology and management of POI in horses, most studies seem to apply research findings to the clinical case without full regard for the clinical evidence. Although much attention has focused recently on the role of inflammation, this narrow focus might explain our failure to make important advances in managing horses with this complication. This commentary is offered to redirect our current thinking about POI away from an approach that predominantly emphasises a functional disorder and medical management, to one that addresses surgical prevention.

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Section: Post‐operative Feedingmentioning

confidence: 99%

Post‐operative reflux – a surgeon's perspective

Freeman

2017

Equine Veterinary Education

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“…Enhanced Recovery After Surgery (ERAS) concept, also known as "fast-track surgery" or "multimodal rehabilitation after surgery", was developed in the early 90s when a group of researchers stated different approaches to improve postoperative recovery in patients undergoing elective Surgery [1][2][3] of hospital stay and minimization of inherent complications of Surgery [4,5] .…”

Section: Introductionmentioning

confidence: 99%

Development of a “Fast-Track” Protocol for Hydrocele Surgery

Verdejo¹

2016

JAS

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“…This is in contrast to the traditional practice of fasting plus the intravenous administration of glucose during perioperative periods [7]. To avoid preoperative starvation, patients are allowed to take solid food until 6 h before the administration of anesthesia and are encouraged to take only clear fluids without fat or milk up to 2 h before [8], and then restart meals soon after surgery. Therefore, patients experience less thirst, hunger, and anxiety [9-13].…”

Section: Introductionmentioning

confidence: 99%

GLP1 Receptor Agonist Liraglutide Is an Effective Therapeutic Option for Perioperative Glycemic Control in Type 2 Diabetes within Enhanced Recovery After Surgery (ERAS) Protocols

Kaneko

Ueda

Tahara³

2018

Eur Surg Res

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Background: Enhanced Recovery After Surgery (ERAS) protocols are multimodal perioperative care pathways designed to achieve early recovery after surgical procedures by maintaining preoperative organ function and reducing profound stress responses following surgery [Wilmore and Kehlet: BMJ 2001; 322(7284): 473–6]. Glucagon-like peptide-1 receptor agonists (GLP-1RAgs), such as liraglutide, have recently been widely used as antidiabetic agents in patients with type 2 diabetes (T2D) because they maintain blood glucose at an ideal level throughout the day, including during postprandial periods, thereby improving hypoglycemia and body weight more than insulin therapies. Additionally, the administration of liraglutide may exert cardiovascular, renal, and cerebral protective effects in T2D patients. The use of GLP-1RAgs for perioperative glycemic control is sometimes considered to be controversial. Methods: The efficacy and safety of liraglutide therapy during perioperative glycemic control in elective surgery patients within ERAS protocols were compared with those of insulin therapy. Ninety adult T2D patients scheduled to undergo elective surgery within ERAS protocols were randomized and analyzed. Forty-nine subjects were prescribed liraglutide and 41 insulin therapy. Procedures comprised orthopedic, thoracic, urological, otolaryngological, hepatic resection, and gynecological breast surgeries. Results: Liraglutide was shown to be a more effective option than insulin therapy because (1) glycemic levels were more stable; (2) the number of patients requiring additional insulin according to the insulin sliding scale was significantly smaller (Fisher’s exact test, p = 0.005); (3) the insulin dosage required on the day of surgery was significantly smaller (Fisher’s exact, p = 0.004); (4) the additional insulin volume required was significantly less for patients throughout the perioperative period (Fisher’s exact test, p = 0.001); and (5) while lean body mass remained the same, body fat measurements, particularly visceral fat, tended to decrease. Conclusions: Based on the results of the present study and a recent large-scale clinical study showing cardiovascular and renal protective effects in T2D patients, we consider the administration of liraglutide within ERAS protocols for T2D patients to represent a more comprehensive suite of patient protection measures as a perioperative non-insulin agent, particularly in patients with limited exercise ability and those at risk of hypoglycemia.

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Fast-track surgery: Toward comprehensive peri-operative care

Cited by 57 publications

References 46 publications

Post‐operative reflux – a surgeon's perspective

Post‐operative reflux – a surgeon's perspective

Development of a “Fast-Track” Protocol for Hydrocele Surgery

GLP1 Receptor Agonist Liraglutide Is an Effective Therapeutic Option for Perioperative Glycemic Control in Type 2 Diabetes within Enhanced Recovery After Surgery (ERAS) Protocols

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