The present systematic review shows that , with the exception of laparoscopic surgery , objective evidence of the effect of individual components of ERAS protocol s in reducing the stress response following colorectal surgery is limited
Abstract Enhanced Recovery or Fast Track Recovery after Surgery protocol s ( ERAS ) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery .
Preoperative Gastric Emptying Effects of Anxiety and Oral Carbohydrate Administration
Background Overnight fasting is routine before elective surgery . This may not be the optimal way to prepare for surgical stress , however , because intravenous carbohydrate supplementation instead of fasting has recently been shown to reduce postoperative insulin resistance . In the current study , gastric emptying of a carbohydrate-rich drink was investigated before elective surgery and in a control situation . Methods Twelve patients scheduled for elective surgery were r and omly given 400 mL of either a carbohydrate-rich drink ( 285 mOsm/kg , 12.0 % carbohydrates , n = 6 ) or water 4 hours before being anesthetized . Gastric emptying was measured ( gamma camera , 99Tcm ) . Each patient repeated the protocol postoperatively as a control . All values were presented as the mean ± SEM by means of a nonparametric statistical evaluation . Results Despite the increased anxiety experienced by patients before surgery ( p < 0.005 ) , gastric emptying did not differ between the experimental and control situations . Initially , water emptied more rapidly than carbohydrate . However , after 90 minutes , the stomach was emptied regardless of the solution administered ( 3.2 ± 1.1 % [ mean ± SEM ] remaining in the stomach in the carbohydrate group versus 2.3 ± 1.2 % remaining in the stomach in the water group ) . Conclusions Preoperative anxiety does not prolong gastric emptying . The stomach had been emptied 90 minutes after Ingestion of both the carbohydrate-rich drink and water , thereby indicating the possibility of allowing an intake of iso-osmolar carbohydrate-rich fluids before surgery
The present systematic review shows that , with the exception of laparoscopic surgery , objective evidence of the effect of individual components of ERAS protocol s in reducing the stress response following colorectal surgery is limited
Abstract Enhanced Recovery or Fast Track Recovery after Surgery protocol s ( ERAS ) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery .