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 .
Enforced mobilization, early oral feeding, and balanced analgesia improve convalescence after colorectal surgery.
OBJECTIVE A postoperative regimen using a multimodal approach with enforced mobilization and early oral nutrition has been reported to improve convalescence but has not been compared with other postoperative regimens . METHODS Forty patients undergoing elective colorectal surgery were r and omly allocated to an intervention group receiving comprehensive information on the importance of mobilization , balanced anesthesia , and postoperative analgesia including epidural local anesthetics and enforced postoperative mobilization or a control group receiving anesthesia without epidural local anesthetics , postoperative analgesia with epidural morphine , and mobilization without fixed goals . All patients were offered early oral nutrition . The regimens were compared by means of ambulation time and physical activity , voluntary muscle strength , pulmonary function , and body composition . RESULTS The ambulation time improved substantially within 22 h in the intervention group versus 3 h in the control group on day 1 ( P = 0.0004 ) and within 8 h versus 2 h on day 4 ( P = 0.0003 ) . The voluntary strength of the quadriceps muscle decreased by 3 % in the intervention group versus 15 % in the control group on day 7 ( P = 0.04 ) . Two months postoperatively , the difference between groups was the same ( P = 0.02 ) . CONCLUSION This active per- and postoperative regimen based on a multimodal approach improved ambulation time and muscle function during admission and late convalescence
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 .