Implementing a fast-track protocol for patients undergoing bowel resection: not so fast

A systematic review of feeding practices among postoperative patients: is practice in‐line with evidenced‐based guidelines?

“…Figure provides details on the search strategy undertaken, including potential study identification, screening, eligibility and inclusion. Overall, 29 papers met the eligibility criteria and were included in the review .…”

“…following feeding), ranging from 23% (71) to 39% (48) . Of the remaining studies, two reported low rates of perceived postoperative nausea (6% and a median score of one out of 10) (51,72) and one reported a higher prevalence of postoperative nausea (45%) and vomiting (26%) (63) in the postoperative period. Few studies (n = 3) reported perceived thirst (range 63-74%) and hunger (range 38-60%) prevalence among postoperative patients (D0-D1) (51,52,59) .…”

“…Only five studies (17%) reported data on the prevalence of postoperative nausea and/or vomiting (PONV), which are factors that may directly impact on oral/enteral intake (48,51,63,71,72) . Two studies reported PONV prevalence in the context of postprandial feeding (i.e.…”

Effects of intravenously infused lidocaine on analgesia and gastrointestinal function of patients receiving laparoscopic common bile duct exploration

“…Hence, it is of great significance to relieve their pain and emotional stress so as to maintain comfortable recovery, to reduce the incidence rate of perioperative cardiovascular adverse reactions, and to allow early ambulation. 12 It has previously been reported that perioperative intravenous injection of lidocaine can enhance the postoperative analgesic effect and accelerate early recovery, and that intraoperative continuous infusion can effectively prevent central hyperalgesia through the nociceptive pathway. 13 In this study, pain score of the treatment group, which was significantly lower than that of the control group at the postoperative 2 hour (P<0.05), was similar to those of the control group at the postoperative 12 hour and 48 hour.…”

Is fast track rehabilitation already standard in gastrointestinal surgery?

“…But discussing the details of the fast track recovery program, listening to presentations of fast track experiences or analyzing recent papers published on this issue, you can recognize, that there are no clear definitions about the essential elements to fulfill for the definition of a fast track recovery program and on the other hand the degree of fulfillment remains unsatisfactory. Moreover different institutions seem to have their own interpretation of fast track by changing ore selecting elements of the fast track protocol [5,6].…”