Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 1: pathophysiological considerations

M J Scott, G Baldini, K C H Fearon, A Feldheiser, L S Feldman, T J Gan, O Ljungqvist, D N Lobo, T A Rockall, T Schricker, F Carli, M J Scott, G Baldini, K C H Fearon, A Feldheiser, L S Feldman, T J Gan, O Ljungqvist, D N Lobo, T A Rockall, T Schricker, F Carli

Abstract

Background: The present article has been written to convey concepts of anaesthetic care within the context of an Enhanced Recovery After Surgery (ERAS) programme, thus aligning the practice of anaesthesia with the care delivered by the surgical team before, during and after surgery.

Methods: The physiological principles supporting the implementation of the ERAS programmes in patients undergoing major abdominal procedures are reviewed using an updated literature search and discussed by a multidisciplinary group composed of anaesthesiologists and surgeons with the aim to improve perioperative care.

Results: The pathophysiology of some key perioperative elements disturbing the homoeostatic mechanisms such as insulin resistance, ileus and pain is here discussed.

Conclusions: Evidence-based strategies aimed at controlling the disruption of homoeostasis need to be evaluated in the context of ERAS programmes. Anaesthesiologists could, therefore, play a crucial role in facilitating the recovery process.

© 2015 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

Figures

Figure 1
Figure 1
ERAS elements. Reproduced from Varadhan KK et al. with permission.105
Figure 2
Figure 2
Perioperative fluid administration with and without an ERAS surgical pathway: risk of perioperative fluid excess and tissue hypoperfusion.104 Reproduced from Minto G et al. with permission.
Figure 3
Figure 3
Pathogenesis of post‐operative ileus. MLC, myosin light chain; STAT, signal transducer and activator of transcription; TNF, tumour necrosis factor; VIP, vasoactive intestinal polypeptide. From Bragg et al. with permission.74
Figure 4
Figure 4
Post‐operative pain: physiological consequences and impact on outcomes and ERAS protocol. CNS, Central Nervous System; HPA axis, Hypothalamic‐Pituitary‐Adrenal axis; CV, Cardiovascular; HR, Heart Rate; SVR, Systemic Vascular Resistance; MRO2, Metabolic Rate of Oxygen; FRC, Functional Residual Capacity; VC, Vital Capacity; MV, Minute Ventilation; GI, Gastrointestinal; ADH, Antidiuretic Hormone; PG, Prostaglandins; UO, Urinary Output; UR, Urinary Retention; VTE, Venous Thromboembolism; IR, Insulin Resistance. Reproduced from Cologne K et al. with permission.106

References

    1. Kehlet H, Wilmore DW. Evidence‐based surgical care and the evolution of fast‐track surgery. Ann Surg 2008; 248: 189–98.
    1. Breuer JP, von Dossow V, von Heymann C, Griesbach M, von Schickfus M, Mackh E, Hacker C, Elgeti U, Konertz W, Wernecke KD, Spies CD. Preoperative oral carbohydrate administration to ASA III‐IV patients undergoing elective cardiac surgery. Anesth Analg 2006; 103: 1099–108.
    1. Larsen K, Hvass KE, Hansen TB, Thomsen PB, Soballe K. Effectiveness of accelerated perioperative care and rehabilitation intervention compared to current intervention after hip and knee arthroplasty. A before‐after trial of 247 patients with a 3‐month follow‐up. BMC Musculoskelet Disord 2008; 9: 59.
    1. Fearon KC, Ljungqvist O, Von Meyenfeldt M, Revhaug A, Dejong CH, Lassen K, Nygren J, Hausel J, Soop M, Andersen J, Kehlet H. Enhanced recovery after surgery: a consensus review of clinical care for patients undergoing colonic resection. Clin Nutr 2005; 24: 466–77.
    1. Gustafsson UO, Scott MJ, Schwenk W, Demartines N, Roulin D, Francis N, McNaught CE, Macfie J, Liberman AS, Soop M, Hill A, Kennedy RH, Lobo DN, Fearon K, Ljungqvist O, Enhanced Recovery After Surgery Society fPC, European Society for Clinical N, Metabolism, International Association for Surgical M, Nutrition . Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS((R))) Society recommendations. World J Surg 2013; 37: 259–84.
    1. Nygren J, Thacker J, Carli F, Fearon KC, Norderval S, Lobo DN, Ljungqvist O, Soop M, Ramirez J, Enhanced Recovery After Surgery Society fPC, European Society for Clinical N, Metabolism, International Association for Surgical M, Nutrition . Guidelines for perioperative care in elective rectal/pelvic surgery: Enhanced Recovery After Surgery (ERAS((R))) Society recommendations. World J Surg 2013; 37: 285–305.
    1. Lassen K, Coolsen MM, Slim K, Carli F, de Aguilar‐Nascimento JE, Schafer M, Parks RW, Fearon KC, Lobo DN, Demartines N, Braga M, Ljungqvist O, Dejong CH, Enhanced Recovery After Surgery Society fPC, European Society for Clinical N, Metabolism, International Association for Surgical M, Nutrition . Guidelines for perioperative care for pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS(R)) Society recommendations. World J Surg 2013; 37: 240–58.
    1. Lassen K, Soop M, Nygren J, Cox PB, Hendry PO, Spies C, von Meyenfeldt MF, Fearon KC, Revhaug A, Norderval S, Ljungqvist O, Lobo DN, Dejong CH, Enhanced Recovery After Surgery G . Consensus review of optimal perioperative care in colorectal surgery: Enhanced Recovery After Surgery (ERAS) Group recommendations. Arch Surg 2009; 144: 961–9.
    1. Gustafsson UO, Hausel J, Thorell A, Ljungqvist O, Soop M, Nygren J, Enhanced Recovery After Surgery Study G . Adherence to the enhanced recovery after surgery protocol and outcomes after colorectal cancer surgery. Arch Surg 2011; 146: 571–7.
    1. Varadhan KK, Neal KR, Dejong CH, Fearon KC, Ljungqvist O, Lobo DN. The enhanced recovery after surgery (ERAS) pathway for patients undergoing major elective open colorectal surgery: a meta‐analysis of randomized controlled trials. Clin Nutr 2010; 29: 434–40.
    1. Pearse RM, Harrison DA, James P, Watson D, Hinds C, Rhodes A, Grounds RM, Bennett ED. Identification and characterisation of the high‐risk surgical population in the United Kingdom. Crit Care 2006; 10: R81.
    1. Wilson RJ, Davies S, Yates D, Redman J, Stone M. Impaired functional capacity is associated with all‐cause mortality after major elective intra‐abdominal surgery. Br J Anaesth 2010; 105: 297–303.
    1. Rostagno C, Olivo G, Comeglio M, Boddi V, Banchelli M, Galanti G, Gensini GF. Prognostic value of 6‐minute walk corridor test in patients with mild to moderate heart failure: comparison with other methods of functional evaluation. Eur J Heart Fail 2003; 5: 247–52.
    1. Lee L, Schwartzman K, Carli F, Zavorsky GS, Li C, Charlebois P, Stein B, Liberman AS, Fried GM, Feldman LS. The association of the distance walked in 6 min with pre‐operative peak oxygen consumption and complications 1 month after colorectal resection. Anaesthesia 2013; 68: 811–6.
    1. Hughes S. The effects of giving patients pre‐operative information. Nurs Stand 2002; 16: 33–7.
    1. Khuri SF, Henderson WG, DePalma RG, Mosca C, Healey NA, Kumbhani DJ, Participants in the VANSQIP . Determinants of long‐term survival after major surgery and the adverse effect of postoperative complications. Ann Surg 2005; 242: 326–41; discussion 41‐3.
    1. Botto F, Alonso‐Coello P, Chan MT, Villar JC, Xavier D, Srinathan S, Guyatt G, Cruz P, Graham M, Wang CY, Berwanger O, Pearse RM, Biccard BM, Abraham V, Malaga G, Hillis GS, Rodseth RN, Cook D, Polanczyk CA, Szczeklik W, Sessler DI, Sheth T, Ackland GL, Leuwer M, Garg AX, Lemanach Y, Pettit S, Heels‐Ansdell D, Luratibuse G, Walsh M, Sapsford R, Schunemann HJ, Kurz A, Thomas S, Mrkobrada M, Thabane L, Gerstein H, Paniagua P, Nagele P, Raina P, Yusuf S, Devereaux PJ, Devereaux PJ, Sessler DI, Walsh M, Guyatt G, McQueen MJ, Bhandari M, Cook D, Bosch J, Buckley N, Yusuf S, Chow CK, Hillis GS, Halliwell R, Li S, Lee VW, Mooney J, Polanczyk CA, Furtado MV, Berwanger O, Suzumura E, Santucci E, Leite K, Santo JA, Jardim CA, Cavalcanti AB, Guimaraes HP, Jacka MJ, Graham M, McAlister F, McMurtry S, Townsend D, Pannu N, Bagshaw S, Bessissow A, Bhandari M, Duceppe E, Eikelboom J, Ganame J, Hankinson J, Hill S, Jolly S, Lamy A, Ling E, Magloire P, Pare G, Reddy D, Szalay D, Tittley J, Weitz J, Whitlock R, Darvish‐Kazim S, Debeer J, Kavsak P, Kearon C, Mizera R, O'Donnell M, McQueen M, Pinthus J, Ribas S, Simunovic M, Tandon V, Vanhelder T, Winemaker M, Gerstein H, McDonald S, O'Bryne P, Patel A, Paul J, Punthakee Z, Raymer K, Salehian O, Spencer F, Walter S, Worster A, Adili A, Clase C, Cook D, Crowther M, Douketis J, Gangji A, Jackson P, Lim W, Lovrics P, Mazzadi S, Orovan W, Rudkowski J, Soth M, Tiboni M, Acedillo R, Garg A, Hildebrand A, Lam N, Macneil D, Mrkobrada M, Roshanov PS, Srinathan SK, Ramsey C, John PS, Thorlacius L, Siddiqui FS, Grocott HP, McKay A, Lee TW, Amadeo R, Funk D, McDonald H, Zacharias J, Villar JC, Cortes OL, Chaparro MS, Vasquez S, Castaneda A, Ferreira S, Coriat P, Monneret D, Goarin JP, Esteve CI, Royer C, Daas G, Chan MT, Choi GY, Gin T, Lit LC, Xavier D, Sigamani A, Faruqui A, Dhanpal R, Almeida S, Cherian J, Furruqh S, Abraham V, Afzal L, George P, Mala S, Schunemann H, Muti P, Vizza E, Wang CY, Ong GS, Mansor M, Tan AS, Shariffuddin II, Vasanthan V, Hashim NH, Undok AW, Ki U, Lai HY, Ahmad WA, Razack AH, Malaga G, Valderrama‐Victoria V, Loza‐Herrera JD, De Los Angeles Lazo M, Rotta‐Rotta A, Szczeklik W, Sokolowska B, Musial J, Gorka J, Iwaszczuk P, Kozka M, Chwala M, Raczek M, Mrowiecki T, Kaczmarek B, Biccard B, Cassimjee H, Gopalan D, Kisten T, Mugabi A, Naidoo P, Naidoo R, Rodseth R, Skinner D, Torborg A, Paniagua P, Urrutia G, Maestre ML, Santalo M, Gonzalez R, Font A, Martinez C, Pelaez X, De Antonio M, Villamor JM, Garcia JA, Ferre MJ, Popova E, Alonso‐Coello P, Garutti I, Cruz P, Fernandez C, Palencia M, Diaz S, Del Castillo T, Varela A, deMiguel A , Munoz M, Pineiro P, Cusati G, Del Barrio M, Membrillo MJ, Orozco D, Reyes F, Sapsford RJ, Barth J, Scott J, Hall A, Howell S, Lobley M, Woods J, Howard S, Fletcher J, Dewhirst N, Williams C, Rushton A, Welters I, Leuwer M, Pearse R, Ackland G, Khan A, Niebrzegowska E, Benton S, Wragg A, Archbold A, Smith A, McAlees E, Ramballi C, Macdonald N, Januszewska M, Stephens R, Reyes A, Paredes LG, Sultan P, Cain D, Whittle J, Del Arroyo AG, Sessler DI, Kurz A, Sun Z, Finnegan PS, Egan C, Honar H, Shahinyan A, Panjasawatwong K, Fu AY, Wang S, Reineks E, Nagele P, Blood J, Kalin M, Gibson D, Wildes T, Vascular events In noncardiac Surgery patIents cOhort evaluatioN Writing Group oboTVeInSpceI, Appendix 1. The Vascular events In noncardiac Surgery patIents cOhort evaluatio NSIWG, Appendix 2. The Vascular events In noncardiac Surgery patIents cOhort evaluatio NOC, Vascular events In noncardiac Surgery patIents cOhort evaluatio NVSI . Myocardial injury after noncardiac surgery: a large, international, prospective cohort study establishing diagnostic criteria, characteristics, predictors, and 30‐day outcomes. Anesthesiology 2014; 120: 564–78.
    1. Greco M, Capretti G, Beretta L, Gemma M, Pecorelli N, Braga M. Enhanced recovery program in colorectal surgery: a meta‐analysis of randomized controlled trials. World J Surg 2014; 38: 1531–41.
    1. Ljungqvist O, Jonathan E. Rhoads lecture 2011: insulin resistance and enhanced recovery after surgery. JPEN J Parenter Enteral Nutr 2012; 36: 389–98.
    1. Thorell A, Nygren J, Ljungqvist O. Insulin resistance: a marker of surgical stress. Curr Opin Clin Nutr Metab Care 1999; 2: 69–78.
    1. Sato H, Carvalho G, Sato T, Lattermann R, Matsukawa T, Schricker T. The association of preoperative glycemic control, intraoperative insulin sensitivity, and outcomes after cardiac surgery. J Clin Endocrinol Metab 2010; 95: 4338–44.
    1. Krinsley JS. Association between hyperglycemia and increased hospital mortality in a heterogeneous population of critically ill patients. Mayo Clin Proc 2003; 78: 1471–8.
    1. McAlister FA, Man J, Bistritz L, Amad H, Tandon P. Diabetes and coronary artery bypass surgery: an examination of perioperative glycemic control and outcomes. Diabetes Care 2003; 26: 1518–24.
    1. Kiran RP, Turina M, Hammel J, Fazio V. The clinical significance of an elevated postoperative glucose value in nondiabetic patients after colorectal surgery: evidence for the need for tight glucose control? Ann Surg 2013;258:599–604; discussion 04–5.
    1. Umpierrez GE, Isaacs SD, Bazargan N, You X, Thaler LM, Kitabchi AE. Hyperglycemia: an independent marker of in‐hospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab 2002; 87: 978–82.
    1. Schricker T, Lattermann R. Strategies to attenuate the catabolic response to surgery and improve perioperative outcomes. Can J Anaesth 2007; 54: 414–9.
    1. Schricker T, Gougeon R, Eberhart L, Wykes L, Mazza L, Carvalho G, Carli F. Type 2 diabetes mellitus and the catabolic response to surgery. Anesthesiology 2005; 102: 320–6.
    1. Donatelli F, Corbella D, Di Nicola M, Carli F, Lorini L, Fumagalli R, Biolo G. Preoperative insulin resistance and the impact of feeding on postoperative protein balance: a stable isotope study. J Clin Endocrinol Metab 2011; 96: E1789–97.
    1. Guillet C, Prod'homme M, Balage M, Gachon P, Giraudet C, Morin L, Grizard J, Boirie Y. Impaired anabolic response of muscle protein synthesis is associated with S6K1 dysregulation in elderly humans. FASEB J 2004;18:1586–7.
    1. Leurs LJ, Laheij RJ, Buth J, Collaborators E. Influence of diabetes mellitus on the endovascular treatment of abdominal aortic aneurysms. J Endovasc Ther 2005; 12: 288–96.
    1. Lieffers JR, Bathe OF, Fassbender K, Winget M, Baracos VE. Sarcopenia is associated with postoperative infection and delayed recovery from colorectal cancer resection surgery. Br J Cancer 2012; 107: 931–6.
    1. Gustafsson UO, Thorell A, Soop M, Ljungqvist O, Nygren J. Haemoglobin A1c as a predictor of postoperative hyperglycaemia and complications after major colorectal surgery. Br J Surg 2009; 96: 1358–64.
    1. Halkos ME, Puskas JD, Lattouf OM, Kilgo P, Kerendi F, Song HK, Guyton RA, Thourani VH. Elevated preoperative hemoglobin A1c level is predictive of adverse events after coronary artery bypass surgery. J Thorac Cardiovasc Surg 2008; 136: 631–40.
    1. O'Sullivan CJ, Hynes N, Mahendran B, Andrews EJ, Avalos G, Tawfik S, Lowery A, Sultan S. Haemoglobin A1c (HbA1C) in non‐diabetic and diabetic vascular patients. Is HbA1C an independent risk factor and predictor of adverse outcome? Eur J Vasc Endovasc Surg 2006; 32: 188–97.
    1. Ljungqvist O. Modulating postoperative insulin resistance by preoperative carbohydrate loading. Best Pract Res Clin Anaesthesiol 2009; 23: 401–9.
    1. Ljungqvist O, Thorell A, Gutniak M, Haggmark T, Efendic S. Glucose infusion instead of preoperative fasting reduces postoperative insulin resistance. J Am Coll Surg 1994; 178: 329–36.
    1. Nygren J, Soop M, Thorell A, Efendic S, Nair KS, Ljungqvist O. Preoperative oral carbohydrate administration reduces postoperative insulin resistance. Clin Nutr 1998; 17: 65–71.
    1. Svanfeldt M, Thorell A, Hausel J, Soop M, Nygren J, Ljungqvist O. Effect of “preoperative” oral carbohydrate treatment on insulin action–a randomised cross‐over unblinded study in healthy subjects. Clin Nutr 2005; 24: 815–21.
    1. Wang ZG, Wang Q, Wang WJ, Qin HL. Randomized clinical trial to compare the effects of preoperative oral carbohydrate versus placebo on insulin resistance after colorectal surgery. Br J Surg 2010; 97: 317–27.
    1. Yuill KA, Richardson RA, Davidson HI, Garden OJ, Parks RW. The administration of an oral carbohydrate‐containing fluid prior to major elective upper‐gastrointestinal surgery preserves skeletal muscle mass postoperatively–a randomised clinical trial. Clin Nutr 2005; 24: 32–7.
    1. Hausel J, Nygren J, Thorell A, Lagerkranser M, Ljungqvist O. Randomized clinical trial of the effects of oral preoperative carbohydrates on postoperative nausea and vomiting after laparoscopic cholecystectomy. Br J Surg 2005; 92: 415–21.
    1. Yagci G, Can MF, Ozturk E, Dag B, Ozgurtas T, Cosar A, Tufan T. Effects of preoperative carbohydrate loading on glucose metabolism and gastric contents in patients undergoing moderate surgery: a randomized, controlled trial. Nutrition 2008; 24: 212–6.
    1. Awad S, Varadhan KK, Ljungqvist O, Lobo DN. A meta‐analysis of randomised controlled trials on preoperative oral carbohydrate treatment in elective surgery. Clin Nutr 2013; 32: 34–44.
    1. Smith MD, McCall J, Plank L, Herbison GP, Soop M, Nygren J. Preoperative carbohydrate treatment for enhancing recovery after elective surgery. Cochrane Database Syst Rev 2014; 8: CD009161.
    1. American Society of Anesthesiologists Committee . Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anesthesiologists Committee on Standards and Practice Parameters. Anesthesiology 2011; 114: 495–511.
    1. Soreide E, Eriksson LI, Hirlekar G, Eriksson H, Henneberg SW, Sandin R, Raeder J. Pre‐operative fasting guidelines: an update. Acta Anaesthesiol Scand 2005; 49: 1041–7.
    1. Spies CD, Breuer JP, Gust R, Wichmann M, Adolph M, Senkal M, Kampa U, Weissauer W, Schleppers A, Soreide E, Martin E, Kaisers U, Falke KJ, Haas N, Kox WJ. Klinik fur Anasthesiologie und operative Intensivmedizin C‐UB [Preoperative fasting. An update]. Anaesthesist 2003; 52: 1039–45.
    1. Carli F, Halliday D. Continuous epidural blockade arrests the postoperative decrease in muscle protein fractional synthetic rate in surgical patients. Anesthesiology 1997; 86: 1033–40.
    1. Schricker T, Meterissian S, Wykes L, Eberhart L, Lattermann R, Carli F. Postoperative protein sparing with epidural analgesia and hypocaloric dextrose. Ann Surg 2004; 240: 916–21.
    1. Popping DM, Elia N, Marret E, Remy C, Tramer MR. Protective effects of epidural analgesia on pulmonary complications after abdominal and thoracic surgery: a meta‐analysis. Arch Surg 2008; 143: 990–9; discussion 1000.
    1. Popping DM, Elia N, Van Aken HK, Marret E, Schug SA, Kranke P, Wenk M, Tramer MR. Impact of epidural analgesia on mortality and morbidity after surgery: systematic review and meta‐analysis of randomized controlled trials. Ann Surg 2014; 259: 1056–67.
    1. Lewis SJ, Andersen HK, Thomas S. Early enteral nutrition within 24 h of intestinal surgery versus later commencement of feeding: a systematic review and meta‐analysis. J Gastrointest Surg 2009; 13: 569–75.
    1. Soop M, Carlson GL, Hopkinson J, Clarke S, Thorell A, Nygren J, Ljungqvist O. Randomized clinical trial of the effects of immediate enteral nutrition on metabolic responses to major colorectal surgery in an enhanced recovery protocol. Br J Surg 2004; 91: 1138–45.
    1. Brandi LS, Frediani M, Oleggini M, Mosca F, Cerri M, Boni C, Pecori N, Buzzigoli G, Ferrannini E. Insulin resistance after surgery: normalization by insulin treatment. Clin Sci (Lond) 1990; 79: 443–50.
    1. van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, Bouillon R. Intensive insulin therapy in critically ill patients. N Engl J Med 2001; 345: 1359–67.
    1. Investigators N‐SS, Finfer S, Chittock DR, Su SY, Blair D, Foster D, Dhingra V, Bellomo R, Cook D, Dodek P, Henderson WR, Hebert PC, Heritier S, Heyland DK, McArthur C, McDonald E, Mitchell I, Myburgh JA, Norton R, Potter J, Robinson BG, Ronco JJ. Intensive versus conventional glucose control in critically ill patients. N Engl J Med 2009; 360: 1283–97.
    1. Brown SR, Goodfellow PB. Transverse verses midline incisions for abdominal surgery. Cochrane Database Syst Rev 2005; CD005199 DOI: .
    1. Grantcharov TP, Rosenberg J. Vertical compared with transverse incisions in abdominal surgery. Eur J Surg 2001; 167: 260–7.
    1. Seiler CM, Deckert A, Diener MK, Knaebel HP, Weigand MA, Victor N, Buchler MW. Midline versus transverse incision in major abdominal surgery: a randomized, double‐blind equivalence trial (POVATI: ISRCTN60734227). Ann Surg 2009; 249: 913–20.
    1. Schwenk W, Haase O, Neudecker J, Muller JM. Short term benefits for laparoscopic colorectal resection. Cochrane Database Syst Rev 2005; CD003145 DOI: .
    1. Dowson HM, Bong JJ, Lovell DP, Worthington TR, Karanjia ND, Rockall TA. Reduced adhesion formation following laparoscopic versus open colorectal surgery. Br J Surg 2008; 95: 909–14.
    1. Levy B, Dowson HM, Fawcett WJ, Scott MJP, Stoneham JR, Zuleika M, Rockall TA. The effect of regional anaesthesia on haemodynamic changes occurring during laparoscopic colorectal surgery. Anaesthesia 2009;64:810.
    1. Haverkamp MP, de Roos MA, Ong KH. The ERAS protocol reduces the length of stay after laparoscopic colectomies. Surg Endosc 2012; 26: 361–7.
    1. Varadhan KK, Atkins RP, Constantin‐Teodosiu D, Blackshaw E, Perkins AC, Greenhaff PL, Lobo DN. Gastrointestinal surgery mediated increases in gut permeability and expression of IL6 and PDK4 mRNAs in quadriceps muscle may underpin the post‐operative increase in whole‐body insulin resistance in humans. J Am Coll Surg 2011; 213: S53.
    1. Atkins R, Varadhan KK, Constantin‐Teodosiu D, Lobo DN, Greenhaff PL. Rates of skeletal muscle mitochondrial ATP production are reduced during elective abdominal surgery in humans. J Am Coll Surg 2011; 213: S59.
    1. Lobo DN, Bostock KA, Neal KR, Perkins AC, Rowlands BJ, Allison SP. Effect of salt and water balance on recovery of gastrointestinal function after elective colonic resection: a randomised controlled trial. Lancet 2002; 359: 1812–8.
    1. Lobo DN, Stanga Z, Aloysius MM, Wicks C, Nunes QM, Ingram KL, Risch L, Allison SP. Effect of volume loading with 1 liter intravenous infusions of 0.9% saline, 4% succinylated gelatine (Gelofusine) and 6% hydroxyethyl starch (Voluven) on blood volume and endocrine responses: a randomized, three‐way crossover study in healthy volunteers. Crit Care Med 2010; 38: 464–70.
    1. Chowdhury AH, Lobo DN. Fluids and gastrointestinal function. Curr Opin Clin Nutr Metab Care 2011; 14: 469–76.
    1. Varadhan KK, Lobo DN. A meta‐analysis of randomised controlled trials of intravenous fluid therapy in major elective open abdominal surgery: getting the balance right. Proc Nutr Soc 2010; 69: 488–98.
    1. Brandstrup B, Svendsen PE, Rasmussen M, Belhage B, Rodt SA, Hansen B, Moller DR, Lundbech LB, Andersen N, Berg V, Thomassen N, Andersen ST, Simonsen L. Which goal for fluid therapy during colorectal surgery is followed by the best outcome: near‐maximal stroke volume or zero fluid balance? Br J Anaesth 2012; 109: 191–9.
    1. Pearse RM, Harrison DA, MacDonald N, Gillies MA, Blunt M, Ackland G, Grocott MP, Ahern A, Griggs K, Scott R, Hinds C, Rowan K, Group OS . Effect of a perioperative, cardiac output‐guided hemodynamic therapy algorithm on outcomes following major gastrointestinal surgery: a randomized clinical trial and systematic review. JAMA 2014; 311: 2181–90.
    1. Srinivasa S, Taylor MH, Singh PP, Lemanu DP, MacCormick AD, Hill AG. Goal‐directed fluid therapy in major elective rectal surgery. Int J Surg 2014; 12: 1467–72.
    1. Pestana D, Espinosa E, Eden A, Najera D, Collar L, Aldecoa C, Higuera E, Escribano S, Bystritski D, Pascual J, Fernandez‐Garijo P, de Prada B, Muriel A, Pizov R. Perioperative goal‐directed hemodynamic optimization using noninvasive cardiac output monitoring in major abdominal surgery: a prospective, randomized, multicenter, pragmatic trial: POEMAS Study (PeriOperative goal‐directed thErapy in Major Abdominal Surgery). Anesth Analg 2014; 119: 579–87.
    1. Bragg D, El‐Sharkawy AM, Psaltis E, Maxwell‐Armstrong CA, Lobo DN. Postoperative ileus: recent developments in pathophysiology and management. Clin Nutr 2015; 34: 367–76.
    1. Tan EK, Cornish J, Darzi AW, Tekkis PP. Meta‐analysis: Alvimopan vs. placebo in the treatment of post‐operative ileus. Aliment Pharmacol Ther 2007; 25: 47–57.
    1. Wang SC, Borison HL. The vomiting center; a critical experimental analysis. Arch Neurol Psychiatry 1950; 63: 928–41.
    1. Wang SC, Borison HL. A new concept of organization of the central emetic mechanism: recent studies on the sites of action of apomorphine, copper sulfate and cardiac glycosides. Gastroenterology 1952; 22: 1–12.
    1. Borison HL. Area postrema: chemoreceptor circumventricular organ of the medulla oblongata. Prog Neurobiol 1989; 32: 351–90.
    1. Watcha MF, White PF. Postoperative nausea and vomiting. Its etiology, treatment, and prevention. Anesthesiology 1992; 77: 162–84.
    1. Gan TJ. Mechanisms underlying postoperative nausea and vomiting and neurotransmitter receptor antagonist‐based pharmacotherapy. CNS Drugs 2007; 21: 813–33.
    1. Gan TJ, Diemunsch P, Habib AS, Kovac A, Kranke P, Meyer TA, Watcha M, Chung F, Angus S, Apfel CC, Bergese SD, Candiotti KA, Chan MT, Davis PJ, Hooper VD, Lagoo‐Deenadayalan S, Myles P, Nezat G, Philip BK, Tramer MR, Society for Ambulatory A . Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg 2014; 118: 85–113.
    1. Kojima Y, Takahashi T, Fujina M, Owyang C. Inhibition of cholinergic transmission by opiates in ileal myenteric plexus is mediated by kappa receptor. Involvement of regulatory inhibitory G protein and calcium N‐channels. J Pharmacol Exp Ther 1994; 268: 965–70.
    1. Buvanendran A, Kroin JS, Della Valle CJ, Kari M, Moric M, Tuman KJ. Perioperative oral pregabalin reduces chronic pain after total knee arthroplasty: a prospective, randomized, controlled trial. Anesth Analg 2010; 110: 199–207.
    1. Samad TA, Moore KA, Sapirstein A, Billet S, Allchorne A, Poole S, Bonventre JV, Woolf CJ. Interleukin‐1beta‐mediated induction of Cox‐2 in the CNS contributes to inflammatory pain hypersensitivity. Nature 2001; 410: 471–5.
    1. Joshi GP. Multimodal analgesia techniques and postoperative rehabilitation. Anesthesiol Clin North Am 2005; 23: 185–202.
    1. Klein M. Postoperative non‐steroidal anti‐inflammatory drugs and colorectal anastomotic leakage. NSAIDs and anastomotic leakage. Dan Med J 2012;59:B4420.
    1. Carli F, Kehlet H, Baldini G, Steel A, McRae K, Slinger P, Hemmerling T, Salinas F, Neal JM. Evidence basis for regional anesthesia in multidisciplinary fast‐track surgical care pathways. Reg Anesth Pain Med 2011; 36: 63–72.
    1. Joshi GP, Bonnet F, Kehlet H, collaboration P . Evidence‐based postoperative pain management after laparoscopic colorectal surgery. Colorectal Dis 2013;15:146–55.
    1. Saczynski JS, Marcantonio ER, Quach L, Fong TG, Gross A, Inouye SK, Jones RN. Cognitive trajectories after postoperative delirium. N Engl J Med 2012; 367: 30–9.
    1. Moller JT, Cluitmans P, Rasmussen LS, Houx P, Rasmussen H, Canet J, Rabbitt P, Jolles J, Larsen K, Hanning CD, Langeron O, Johnson T, Lauven PM, Kristensen PA, Biedler A, van Beem H, Fraidakis O, Silverstein JH, Beneken JE, Gravenstein JS. Long‐term postoperative cognitive dysfunction in the elderly ISPOCD1 study. ISPOCD investigators. International Study of Post‐Operative Cognitive Dysfunction. Lancet 1998; 351: 857–61.
    1. Rasmussen LS, Johnson T, Kuipers HM, Kristensen D, Siersma VD, Vila P, Jolles J, Papaioannou A, Abildstrom H, Silverstein JH, Bonal JA, Raeder J, Nielsen IK, Korttila K, Munoz L, Dodds C, Hanning CD, Moller JT, Investigators I. Does anaesthesia cause postoperative cognitive dysfunction? A randomised study of regional versus general anaesthesia in 438 elderly patients. Acta Anaesthesiol Scand 2003; 47: 260–6.
    1. Degos V, Vacas S, Han Z, van Rooijen N, Gressens P, Su H, Young WL, Maze M. Depletion of bone marrow‐derived macrophages perturbs the innate immune response to surgery and reduces postoperative memory dysfunction. Anesthesiology 2013; 118: 527–36.
    1. Chan MT, Cheng BC, Lee TM, Gin T. BIS‐guided anesthesia decreases postoperative delirium and cognitive decline. J Neurosurg Anesthesiol 2013; 25: 33–42.
    1. Radtke FM, Franck M, Lendner J, Kruger S, Wernecke KD, Spies CD. Monitoring depth of anaesthesia in a randomized trial decreases the rate of postoperative delirium but not postoperative cognitive dysfunction. Br J Anaesth 2013; 110(Suppl. 1): i98–105.
    1. Lepouse C, Lautner CA, Liu L, Gomis P, Leon A. Emergence delirium in adults in the post‐anaesthesia care unit. Br J Anaesth 2006; 96: 747–53.
    1. Rasmussen LS, Steentoft A, Rasmussen H, Kristensen PA, Moller JT. Benzodiazepines and postoperative cognitive dysfunction in the elderly. ISPOCD Group. International Study of Postoperative Cognitive Dysfunction. Br J Anaesth 1999; 83: 585–9.
    1. Brieger GH. Early ambulation. A study in the history of surgery. Ann Surg 1983; 197: 443–9.
    1. Convertino VA. Cardiovascular consequences of bed rest: effect on maximal oxygen uptake. Med Sci Sports Exerc 1997; 29: 191–6.
    1. Brower RG. Consequences of bed rest. Crit Care Med 2009; 37: S422–8.
    1. Convertino VA, Bloomfield SA, Greenleaf JE. An overview of the issues: physiological effects of bed rest and restricted physical activity. Med Sci Sports Exerc 1997; 29: 187–90.
    1. Bergouignan A, Rudwill F, Simon C, Blanc S. Physical inactivity as the culprit of metabolic inflexibility: evidence from bed‐rest studies. J Appl Physiol 1985. (2011); 111: 1201–10.
    1. Hirsch CH, Sommers L, Olsen A, Mullen L, Winograd CH. The natural history of functional morbidity in hospitalized older patients. J Am Geriatr Soc 1990; 38: 1296–303.
    1. Zargar‐Shoshtari K, Hill AG. Postoperative fatigue: a review. World J Surg 2009; 33: 738–45.
    1. Minto G, Scott MJ, Miller TE. Monitoring needs and goal‐directed fluid therapy within an enhanced recovery program. Anesthesiol Clin 2015; 33: 35–49.
    1. Varadhan KK, Lobo DN, Ljungqvist O. Enhanced Recovery After Surgery: The Future of Improving Surgical Care. Crit Care Clin 2010; 26: 527–47.
    1. Cologne K, Baldini G. The SAGES/ERAS® Society Manual of Enhanced Recovery Programs for Gastrointestinal Surgery. Choosing Analgesia to facilitate Recovery 2015.

Source: PubMed

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