Key recommendations support use of  opioid-sparing perioperative medications  , minimal preoperative fasting and early feeding , use of anesthetic techniques that decrease postoperative nausea and vomiting and pain , use of measures to prevent intraoperative hypothermia , and support of early mobilization after surgery .
Background : Enhanced recovery following surgery can be achieved through the introduction of evidence -based perioperative maneuvers .
This review aims to present a consensus for optimal perioperative management of patients undergoing breast reconstructive surgery  and to provide evidence -based recommendations for an enhanced perioperative protocol .
Early rehabilitation reduces the onset of complications in the upper limb following breast cancer surgery.
BACKGROUND Breast cancer ( BC ) is currently the most frequent tumor in women . Through the years , BC management has evolved towards conservative surgery . However , even minimally invasive surgery can cause neuromotor and /or articular impairments which can lead to permanent damage , if not adequately treated . AIM To clinical ly evaluate upper ipsilateral limb function and the impact of certain post-surgical consequences arising after invasive or breast-conserving surgery for early BC , by intervening , or not intervening , with an early rehabilitation program . To investigate physical morbidity after sentinel ( SLND ) or axillary lymph node dissection ( ALND ) and after reconstructive surgery in the treatment of early BC . DESIGN Observational prospect i ve trial . SETTING Inpatient and outpatient treatment . POPULATION Eighty-three females participated in the study : 25 patients did not begin physiotherapy during hospitalization ( Group A ) , 58 patients received early rehabilitation treatment ( Group B ) . METHODS The patients of Groups A and B were compared with respect to the following criteria : shoulder-arm mobility , upper limb function , and presence of lymphedema . All patients were assessed at 15 - 30 , 60 and 180 days after surgery . RESULTS Statistically significant differences , in favor of Group B , were encountered at the 180-day follow-up visit , especially with respect to articular and functional limitation of the upper limb . CONCLUSION AND CLINICAL REHABILITATION IMPACT The results of the present study show that early assisted mobilization ( beginning on the first postoperative day ) and home rehabilitation , in conjunction with written information on pre caution ary hygienic measures to observe , play a crucial role in reducing the occurrence of postoperative side-effects of the upper limb
Key recommendations support use of  opioid-sparing perioperative medications  , minimal preoperative fasting and early feeding , use of anesthetic techniques that decrease postoperative nausea and vomiting and pain , use of measures to prevent intraoperative hypothermia , and support of early mobilization after surgery .
Background : Enhanced recovery following surgery can be achieved through the introduction of evidence -based perioperative maneuvers .
This review aims to present a consensus for optimal perioperative management of patients undergoing breast reconstructive surgery  and to provide evidence -based recommendations for an enhanced perioperative protocol .