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 .
Comparison of Sevoflurane versus Propofol under Auditory Evoked Potential Monitoring in Female Patients Undergoing Breast Surgery
Background : General anesthesia is used for most major surgeries , and the most common side effects include headache , nausea , vomiting , and sore throat . Major breast surgery is associated with a high incidence of postoperative nausea and vomiting ( PONV ) . We compared the postoperative nausea and vomiting of propofol-based total intravenous anesthesia ( TIVA ) and sevoflurane ( SEVO ) anesthesia under auditory evoked potential ( AEP ) monitoring in female patients undergoing breast surgery . Methods : A total of 84 patients scheduled to undergo elective breast surgery from 1 to 4 h in duration from March 2011 to December 2011 were prospect ively included in the study . All participants were r and omly assigned to TIVA or SEVO group . The AEP index was maintained at 15 - 25 . After completing the surgery , the duration of surgery , emergence time , and the side effects of PONV were recorded . Results : Patient characteristics , intraoperative and postoperative data , and the amounts of intraoperative analgesic drugs used were not significantly different between the TIVA and SEVO groups . The incidence of PONV was significantly higher in the SEVO group than in the TIVA group ( 50 % and 14.3 % , respectively ; p < 0.001 ) , and the total cost was significantly lower in the TIVA group than in the SEVO group ( 648 ± 185 and 850 ± 197 , respectively ) . Conclusion : We observed that when compared with sevoflurane , propofol given for the maintenance of general anesthesia improves the postoperative patient well-being and reduces the incidence of PONV . Furthermore , total intravenous anesthesia with propofol result ed in significant cost reductions
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 .