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 .
Anesthetic Technique for Radical Prostatectomy Surgery Affects Cancer Recurrence: A Retrospective Analysis
Background : Regional anesthesia and analgesia attenuate or prevent perioperative factors that favor minimal residual disease after removal of the primary carcinoma . Therefore , the authors evaluated prostate cancer recurrence in patients who received either general anesthesia with epidural anesthesia/analgesia or general anesthesia with postoperative opioid analgesia .  Methods : In a retrospective review of medical records , patients with invasive prostatic carcinoma who underwent open radical prostatectomy between January 1994 and December 2003 and had either general anesthesia – epidural analgesia or general anesthesia – opioid analgesia were evaluated through October 2006 . The endpoint was an increase in postoperative prostate-specific antigen . Results : After adjusting for tumor size , Gleason score , preoperative prostate-specific antigen , margin , and date of surgery , the epidural plus general anesthesia group had an estimated 57 % ( 95 % confidence interval , 17–78 % ) lower risk of recurrence compared with the general anesthesia plus opioids group , with a corresponding hazard ratio of 0.43 ( 95 % confidence interval , 0.22–0.83 ; P = 0.012 ) in a multivariable Cox regression model . Gleason score and tumor size ( percent of prostate involved ) were also independent predictors of recurrence ( hazards ratios of 1.19 [ 1.08 , 1.52 ] , P = 0.004 , and 1.17 [ 1.03 , 1.34 ] for 10 % size difference , P = 0.01 , respectively ) . A similar association between epidural use and recurrence was obtained by comparing patients matched on the propensity to receive epidural versus general anesthesia . Conclusions : Open prostatectomy surgery with general anesthesia , substituting epidural analgesia for postoperative opioids , was associated with substantially less risk of biochemical cancer recurrence . Prospect i ve r and omized trials to evaluate this association seem warranted
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 .