Role of Anesthesia in Fast Track Abdominal Surgery

Abstract

Enhanced recovery after surgery (ERAS) protocols, also known as ‘fast-track surgery ’or ‘multimodal optimization’, are a combination of evidence based peri-operative strategies which work synergistically to expedite recovery after surgery. Anesthesiologists are the ones who make the important decisions regarding premedication, fluid management, anesthetic and adjuvant drugs, treatment of side effects, and pain management in the early postoperative period. Interventions to modify surgical stress responses are also performed by anesthesiologists and include perioperative use of β-blockers, glucocorticoid steroids, administration of fluids, as well as control of stress-induced hyperglycemia by administering insulin Pre-operative recommendations including Pre-operative counseling and training, A curtailed fast (6 hours to solids and 2 hours to clear liquids) and pre-operative carbohydrate loading, Avoidance of mechanical bowel preparation, Deep vein thrombosis prophylaxis using low molecular weight heparin and a single dose of prophylactic antibiotics covering both aerobic and anaerobic pathogens. Peri-operative recommendations including high