Implementation of ERAS and how to overcome the barriers

被引：128

作者：

Kahokehr, Arman ^{[1
]}

Sammour, Tarik ^{[1
]}

Zargar-Shoshtari, Kamran ^{[1
]}

Thompson, Lisa ^{[2
]}

Hill, Andrew G. ^{[1
]}

机构：

[1] Univ Auckland, Middlemore Hosp, Dept Surg, S Auckland Clin Sch, Auckland 1, New Zealand

[2] Middlemore Hosp, Manukau Surg Ctr, Auckland 6, New Zealand

来源：

INTERNATIONAL JOURNAL OF SURGERY | 2009年 / 7卷 / 01期

关键词：

ERAS; Fast-track; Multimodal care; Colonic surgery; Enhanced recovery; FAST-TRACK REHABILITATION; RANDOMIZED CLINICAL-TRIAL; EPIDURAL ANALGESIA; COLONIC SURGERY; PERIOPERATIVE MANAGEMENT; MULTIMODAL OPTIMIZATION; ELDERLY-PATIENTS; CARE; RECOVERY; ANESTHESIA;

D O I：

10.1016/j.ijsu.2008.11.004

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background: Multimodal care or Enhanced Recovery after Surgery (ERAS) protocols are gaining popularity in order to modify surgical stress responses after colonic resection. However, these protocols are not straightforward to implement as peri-operative care is varied. We aimed to identify areas that may need attention in order to successfully change practice. Method: The literature was reviewed for current practice, methods and issues in implementing ERAS. Based on this and our own experience we discuss several important areas that need particular attention in developing and sustaining an ERAS program. Results: International surveys have shown that current peri-operative care in colorectal resection is not evidence based. Important aspects of the ERAS philosophy including patient counselling, teamwork and attitude change are identified and discussed. Conclusion: Implementing evidence-based peri-operative care into practice is challenging. Barriers to multimodal recovery pathways should be addressed. (C) 2008 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

引用

页码：16 / 19

页数：4

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