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 .
What influence does intermittent pneumatic compression of the lower limbs intraoperatively have on core hypothermia?
Background Intermittent pneumatic compression ( IPC ) devices have been widely used for thrombosis prophylaxis in laparoscopic colorectal surgery . However , periodic compression using an IPC device may inject augmented boluses of cool blood from the lower limbs into the central circulation repetitively , thereby causing a reduction in core temperature . The authors therefore conducted a prospect i ve , r and omized , double-blind , controlled study to compare the effects of intraoperative IPC on core temperature in patients undergoing laparoscopic colorectal surgery . Methods For this study , 56 patients ages 18–60 years and scheduled to undergo laparoscopic resection for colorectal cancer under general anesthesia were r and omly assigned to receive either no IPC ( control group ) or calf-thigh-length IPC in both legs using the SCD Express ( IPC group ) . Anesthetic , thermal , and pneumoperitoneum management were st and ardized . Esophageal temperature , as an indicator of core temperature , was measured at 15-min intervals for 2 h after induction of anesthesia . Results A total of 47 subjects ( 23 control and 24 IPC subjects ) were included in the analysis . The core temperature drop in the IPC group was significantly greater than in the control group , starting from 45 min after induction of anesthesia ( P < 0.05 ) . As a result , the total temperature drop during the 2-h study period was significantly greater in the IPC group ( 1.2 ± 0.3 ° C ) than in the control group ( 0.9 ± 0.3 ° C ) ( P = 0.004 ) . Conclusions Because intraoperative application of IPC carries an increased risk of a core temperature drop , appropriate temperature monitoring and active thermal management are required for surgical patients receiving IPC
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 .