Zhou et al. BMC Cancer 2011, 11:494 http://www.biomedcentral.com/1471-2407/11/494 Page 5 of 10 Table 1 Checklist of fast track and conventional perioperative operation treatments (Continued) - Morphia as little as possible - Monitoring: (Datex Ohmeda™ S/5 Anesthesia Monitor (Datex-Ohmeda Division, Instrumentarium Corp., Helsinki, Finland)) consists of electrocardiogram (ECG), heart rate (HR), respiratory rate, arterial pressure (BP), SpO2, end-tidal CO2 (etCO2), and bispectral index (BIS). - The target concentration of propofol:keep BIS between 40 and 60 to maintain adequate hypnosis. - Perioperative hypotension:systolic blood pressure (SBP) < 80 mmHg or a decrease of 30% baseline value and was treated with reduction of anesthetics, fluid supplement, and a bolus dose of ephedrine (Mahuangsu™, Northeast Pharmaceutical Co., Ltd., Shenyang, CN) (10 mg, IV). If SBP was above 160 mmHg or increase > 30%, an increase of propofol or remifentanil infusion was given to deepen anesthesia. - Yes, - Yes As equally depth of anesthesia is also needed in conventional treatment group with no thoracic epidural anesthesia, more drug dosage of general anesthesia is used. - No restriction of Morphia use - Monitoring: the same as fast-track group -Antibiotic prophylaxis -Surgical management - Warming - Drains - Fluid infusion Postoperation - Pain management -Laparoscopic/open surgery as randomization -Laparoscopic/open surgery as randomization - Yes, body warming by thickening quilt as well as intravenous fluid warming - Minimal use and early removal of abdominal drains - Totally ≤ 1,500 ml during operation - No body and intravenous fluid warming -Regularly use and removal of abdominal drains - No restriction -Patient-controlled continuous epidural analgesia with a 5 ml/h continuous infusion of 0.15% ropivacaine and a bolus dose of 2.5 ml (locktime 15 min) until 48 h after operation, paracetamol (Tylenol™, Johnson & Johnson Pharmaceutical Co., Ltd., Shanghai, CN) p.o. when needed -Patient-controlled intravenous analgesia with a 4 ug/h continuous infusion of sufentanil and a bolus dose of 1.5 μg (locktime 15 min) -Bucinperazine (QiangtongdingTM, Northeast Pharmaceutical Co., Ltd., Shenyang, CN) or Morphine (Mafei™, Northeast Pharmaceutical Co., Ltd., Shenyang, CN) intramuscular injection when patient-controlled intravenous analgesia isn’t enough for pain control - Diet - Chewing gum 1 piece tid p.o. -No chewing gum - At least 10% Glucose 200 ml p.o. within 24 h after - Fasting until flatus operation -Liquid diet and Enteral Nutritional Emulsion Supportan 200 ml or Fresubin Diabetes 300 ml (especially for patients with diabetes mellitus) p.o. the next day of operation - Diet rehabilitation as early as possible (dose increase of Enteral Nutritional Emulsion or when needed) - Liquid diet after flatus - Normal diet after defecation