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 .
Effects of intravenous fluid restriction on postoperative complications: comparison of two perioperative fluid regimens: a randomized assessor-blinded multicenter trial.
OBJECTIVE To investigate the effect of a restricted intravenous fluid regimen versus a st and ard regimen on complications after colorectal resection . SUMMARY BACKGROUND DATA Current fluid administration in major surgery causes a weight increase of 3 - 6 kg . Complications after colorectal surgery are reported in up to 68 % of patients . Associations between postoperative weight gain and poor survival as well as fluid overload and complications have been shown . METHODS We did a r and omized observer-blinded multicenter trial . After informed consent was obtained , 172 patients were allocated to either a restricted or a st and ard intraoperative and postoperative intravenous fluid regimen . The restricted regimen aim ed at maintaining preoperative body weight ; the st and ard regimen resembled everyday practice . The primary outcome measures were complications ; the secondary measures were death and adverse effects . RESULTS The restricted intravenous fluid regimen significantly reduced postoperative complications both by intention-to-treat ( 33 % versus 51 % , P = 0.013 ) and per- protocol ( 30 % versus 56 % , P = 0.003 ) analyses . The numbers of both cardiopulmonary ( 7 % versus 24 % , P = 0.007 ) and tissue-healing complications ( 16 % versus 31 % , P = 0.04 ) were significantly reduced . No patients died in the restricted group compared with 4 deaths in the st and ard group ( 0 % versus 4.7 % , P = 0.12 ) . No harmful adverse effects were observed . CONCLUSION The restricted perioperative intravenous fluid regimen aim ing at unchanged body weight reduces complications after elective colorectal resection
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 .