Abstract:
BACKGROUND:Despite international data indicating that Enhanced Recovery After Surgery (ERAS) programs, which combine evidence-based perioperative strategies, expedite recovery after surgery, few centers have successfully adopted this approach within the U.S. We describe the implementation and efficacy of an ERAS program for colorectal abdominal surgery in a tertiary teaching center in the U.S. METHODS:We used a multi-modal and continuously evolving approach to implement an ERAS program among all patients undergoing colorectal abdominal surgery at a single hospital at the University of California, San Francisco. 279 patients who participated in the Enhanced Recovery after Surgery program were compared to 245 previous patients who underwent surgery prior to implementation of the program. Primary end points were length of stay and readmission rates. Secondary end points included postoperative pain scores, opioid consumption, postoperative nausea and vomiting, length of urinary catheterization, and time to first solid meal. RESULTS:ERAS decreased both median total hospital length of stay (6.4 to 4.4 days) and post-procedure length of stay (6.0 to 4.1 days). 30-day all-cause readmission rates decreased from 21 to 9.4 %. Pain scores improved on postoperative day 0 (3.2 to 2.1) and day 1 (3.2 to 2.6) despite decreased opioid. Median time to first solid meal decreased from 4.7 to 2.7 days and duration of urinary catheterization decreased from 74 to 46 h. Similar improvements were observed in all other secondary end points. CONCLUSIONS:These results confirm that a multidisciplinary, iterative, team-based approach is associated with a reduction in hospital stay and an acceleration in recovery without increasing readmission rates.
journal_name
BMC Anesthesioljournal_title
BMC anesthesiologyauthors
Sarin A,Litonius ES,Naidu R,Yost CS,Varma MG,Chen LLdoi
10.1186/s12871-016-0223-0subject
Has Abstractpub_date
2016-08-03 00:00:00pages
55issue
1issn
1471-2253pii
10.1186/s12871-016-0223-0journal_volume
16pub_type
杂志文章abstract:BACKGROUND:Fluid overloading is detrimental to organ function and results in a poor prognosis. It is necessary to evaluate fluid responsiveness before fluid loading. We performed a systematic meta-analysis to evaluate the diagnostic value of the respiratory variation in peripheral arterial blood flow peak velocity (△Vp...
journal_title:BMC anesthesiology
pub_type: 杂志文章,meta分析
doi:10.1186/s12871-018-0635-0
更新日期:2018-11-13 00:00:00
abstract:BACKGROUND:The frequency of malpositioning of gastric tubes in the trachea has been reported to be 0.3-15%, which may cause severe complications, such as pneumonia, if not detected promptly. If a gastric tube can be guided into the esophagus under direct vision with a video laryngoscope, misplacement of the gastric tub...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2253-14-82
更新日期:2014-09-25 00:00:00
abstract:BACKGROUND:To determine whether continuous intravenous infusion of dexmedetomidine (DEX) can affect the incidence of Emergence Agitation (EA) after general anesthesia in infant undergoing cleft palate repair surgery. METHODS:Forty infants underwent cleft palate repair surgery under general anesthesia were randomly div...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-015-0124-7
更新日期:2015-10-13 00:00:00
abstract:BACKGROUND:Laryngeal mask airway is a supraglottic airway device which has led to a fundamental change in the management of modern general anesthesia. In the present study; we evaluated the laryngeal mask airway insertion conditions and hemodynamic changes comparing ketamine-propofol mixture (ketofol) with propofol. Th...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0711-0
更新日期:2019-03-20 00:00:00
abstract:BACKGROUND:To identify changes in cefoperazone/sulbactam penetration into cerebrospinal fluid (CSF) after craniotomy and to investigate preliminarily whether cefoperazone/sulbactam CSF concentration can reach therapeutic level when administered intravenously after neurosurgical operation. METHODS:Neurosurgical patient...
journal_title:BMC anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1186/s12871-015-0012-1
更新日期:2015-03-13 00:00:00
abstract:BACKGROUND:Perioperative hemodynamic fluctuations are seen more often in hypertensive patients than in normotensive patients. The purpose of our study was to investigate the perioperative hemodynamic effects of dexmedetomidine and midazolam used for premedication in hypertensive patients relative to each other and in c...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2253-14-113
更新日期:2014-12-10 00:00:00
abstract:BACKGROUND:The effect of adding clonidine to local anesthetics for nerve or plexus blocks remains unclear. Most of the studies in adults have demonstrated the positive effects of clonidine on intra- and postoperative analgesia when used as an adjunctive agent or in some cases as a single to regional techniques. In the ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-12-2
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:The benefits of lung-protective ventilation (LPV) with a low tidal volume (6 mL/kg of ideal body weight [IBW]), limited plateau pressure (< 28-30 cm H2O), and appropriate positive end-expiratory pressure (PEEP) in patients with acute respiratory distress syndrome have become apparent and it is now widely ado...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-018-0495-7
更新日期:2018-04-02 00:00:00
abstract:BACKGROUND:The Zeus® (Dräger, Lübeck, Germany), an automated closed-circuit anesthesia machine, uses high fresh gas flows (FGF) to wash-in the circuit and the lungs, and intermittently flushes the system to remove unwanted N₂. We hypothesized this could increase desflurane consumption to such an extent that agent consu...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-8-4
更新日期:2008-07-17 00:00:00
abstract:BACKGROUND:The quality of patients' recovery following surgery and anesthesia has been a matter of focus and concern over the past decade. The Quality of Recovery-40 (QoR-40) questionnaire was developed and validated for post-anesthesia patient evaluation. The QoR-40, however, is English-based and was tested and valida...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-016-0229-7
更新日期:2016-08-18 00:00:00
abstract:BACKGROUND:Even the best cancer surgery is usually associated with minimal residual disease. Whether these remaining malignant cells develop into clinical recurrence is at least partially determined by adequacy of host defense, especially natural killer cell function. Anesthetics impair immune defenses to varying degre...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-9-1
更新日期:2009-02-03 00:00:00
abstract:BACKGROUND:Renal dysfunction following intraoperative arterial hypotension is mainly caused by an insufficient renal blood flow. It is associated with higher mortality and morbidity rates. We hypothesised that the intraoperative haemodynamics are more stable during xenon anaesthesia than during isoflurane anaesthesia i...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0799-2
更新日期:2019-07-09 00:00:00
abstract:BACKGROUND:Sugammadex, a γ-cyclodextrin derivative, belongs to a new class of selective relaxant binding agents. Sugammadex was approved 10-years ago by the European medicines agency and today is used in clinical anesthesia and emergency medicine globally. In this review, indications for neuromuscular block, the challe...
journal_title:BMC anesthesiology
pub_type: 杂志文章,评审
doi:10.1186/s12871-018-0605-6
更新日期:2018-11-06 00:00:00
abstract:BACKGROUND:Gabapentin is an antiepileptic drug used in a variety of chronic pain conditions. Increasing numbers of randomized trials indicate that gabapentin is effective as a postoperative analgesic. This procedure-specific systematic review aims to analyse the 24-hour postoperative effect of gabapentin on acute pain ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-7-6
更新日期:2007-07-07 00:00:00
abstract:BACKGROUND:Rotational elastometry (ROTEM) has been shown useful to monitor coagulation in trauma patients and in major elective surgery. In this study, we aimed to evaluate the utility of ROTEM to identify hemostatic disturbances and to predict the need for transfusion, compared with standard coagulation tests (SCTs) i...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-017-0440-1
更新日期:2017-10-24 00:00:00
abstract:BACKGROUND:Post-dural puncture headache (PDPH) due to excessive cerebrospinal fluid (CSF) leakage is a well-known complication of lumbar puncture. Although various factors, especially the type of spinal needle, have been demonstrated to be associated with PDPH, the clinical implications of CSF leakage detected on magne...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-13-35
更新日期:2013-10-27 00:00:00
abstract:BACKGROUND:Splenectomy performed with a curved incision results in severe postoperative pain. The aim of this study was to evaluate the effect of transversus abdominis plane block and rectus sheath block on postoperative pain relief and recovery. METHODS:A total of 150 patients were randomized into the control (C), le...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-020-0941-1
更新日期:2020-01-23 00:00:00
abstract:BACKGROUND:Older age is associated with chronic illnesses and disability, which contribute to increased admission to the intensive care unit (ICU). Our primary objective was to compare the characteristics, ICU management and outcomes of critically ill patients ≥ 80 year-old with those of younger patients. METHODS:This...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-14-126
更新日期:2014-12-20 00:00:00
abstract:BACKGROUND:The present study aimed to compare the intravenous bolus effect of oxycodone and fentanyl on hemodynamic response after endotracheal intubation and postoperative pain in patients undergoing closed reduction of nasal bone fracture. METHODS:In this prospective randomized double-blinded study, 64 patients unde...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-016-0279-x
更新日期:2016-11-17 00:00:00
abstract:BACKGROUND:Early prediction of outcome would be useful for an optimal intensive care management of liver transplant recipients. Indocyanine green clearance can be measured non-invasively by pulse spectrophometry and is closely related to liver function. METHODS:This study was undertaken to assess the predictive value ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-14-103
更新日期:2014-11-15 00:00:00
abstract:BACKGROUND:Local anesthetic Bupivacaine commonly used in gastric cancer resection operation has been reported to suppress the progression of gastric cancer. However, the specific mechanism by which Bupivacaine functions is largely unexplored. METHODS:The viability and metastasis of gastric cancer cells were assessed b...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01179-4
更新日期:2020-10-30 00:00:00
abstract:BACKGROUND:Continuous epidural infusion (CEI) is the standard application setting for epidural infusion. A new mode, the programmed intermittent epidural bolus (PIEB) technique, showed reduced local anesthetic (LA) consumption and improved analgesia in obstetric analgesia. Goal of this trial was to evaluate the effects...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-018-0613-6
更新日期:2018-10-30 00:00:00
abstract:BACKGROUND:We report a case of severe upper airway obstruction due to a retropharyngeal hematoma that presented nearly one day after a precipitating traumatic injury. Retropharyngeal hematomas are rare, but may cause life-threatening airway compromise. CASE PRESENTATION:A 50 year-old man developed severe dyspnea with ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-7-2
更新日期:2007-03-12 00:00:00
abstract:BACKGROUND:Maintaining the cuff pressure of endotracheal tubes (ETTs) within 20-30 cmH2O is a standard practice. The aim of the study was to evaluate the effectiveness of standard practice in maintaining cuff pressure within the target range. METHODS:This was a prospective observational study conducted in a tertiary-c...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-015-0132-7
更新日期:2015-10-15 00:00:00
abstract:BACKGROUND:The anaesthetic management of patients with Morquio syndrome is complicated by a number of factors including odontoid hypoplasia, atlantoaxial instability, thoracic kyphosis, and deposition of mucopolysaccharides in the soft tissue of the oropharnyx. CASE PRESENTATION:Herein we describe the anaesthetic cons...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-10-2
更新日期:2010-02-26 00:00:00
abstract:BACKGROUND:Hyperthermic isolated limb perfusion (HILP) is used for patients with intractable or extensive in-transit metastatic melanoma of the limb to deliver high concentrations of cytotoxic agents to the affected limb and offers a treatment option in a disease stage with a poor prognosis when no treatment is given. ...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-13-15
更新日期:2013-07-17 00:00:00
abstract:BACKGROUND:Many cases of coronary artery spasm (CAS) during general plus epidural anesthesia have been reported. But transversus abdominis plane(TAP) block in combination with general anesthesia has not been reported to be a cause of CAS, let alone a life-threatening CAS. CASE PRESENTATION:In this case report, we pres...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-018-0616-3
更新日期:2018-10-20 00:00:00
abstract:BACKGROUND:To investigate the optimal dose of pretreated-dexmedetomidine in fentanyl-induced cough (FIC) suppression. METHODS:Patients of 180 undergoing elective surgery with general anesthesia, aged 18-65 years, BMI 18.5-30 kg/m2, ASA I or II, were equally randomized into four groups (n = 45) to receive intravenous p...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-019-0765-z
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Data on the best norepinephrine bolus dose for management of hypotension are limited. The aim of this study was to compare the efficacy and safety of two norepinephrine bolus doses in the rescue management of maternal hypotension during cesarean delivery. METHODS:This randomized, controlled trial included m...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01004-y
更新日期:2020-04-17 00:00:00
abstract:BACKGROUND:Goal-directed fluid therapy (GDFT) based on dynamic indicators of fluid responsiveness has been shown to decrease postoperative complications and hospital length of stay (LOS) in patients undergoing major abdominal surgery. The usefulness of this approach still needs to be clarified in low-to-moderate risk a...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-019-0707-9
更新日期:2019-03-09 00:00:00