Dissecting the Perioperative Care Bundle

Kyle G Cologne; Christine Hsieh

doi:10.1016/j.suc.2021.05.026

Dissecting the Perioperative Care Bundle

Surg Clin North Am. 2021 Dec;101(6):995-1006. doi: 10.1016/j.suc.2021.05.026. Epub 2021 Aug 25.

Authors

Kyle G Cologne¹, Christine Hsieh²

Affiliations

¹ Division of Colon and Rectal Surgery, Department of Surgery, Keck School of Medicine of the University of Southern California, 1441 Eastlake Avenue, Suite 7418, Los Angeles, CA 90033, USA. Electronic address: kyle.cologne@med.usc.edu.
² Division of Colon and Rectal Surgery, Department of Surgery, Keck School of Medicine of the University of Southern California, 1441 Eastlake Avenue, Suite 7418, Los Angeles, CA 90033, USA.

PMID: 34774277
DOI: 10.1016/j.suc.2021.05.026

Abstract

Enhanced recovery after surgery (ERAS) protocols are comprehensive perioperative care pathways designed to mitigate the physiologic stressors associated with surgery and, in turn, improve clinical outcomes and lead to health care cost savings. Although individual components may differ, ERAS protocols are typically organized as multimodal care "bundles" that, when followed closely and in their entirety, are meant to generate amplified cumulative benefits. This manuscript examines some of the critical components, describes some areas where the science is weak (but dogma may be strong), and provides some of the evidence or lack thereof behind components of a standard ERAS protocol.

Keywords: Enhanced recovery after surgery (ERAS); Enhanced recovery protocols (ERP); Fast-track surgery.

Publication types

Review

MeSH terms

Clinical Protocols / standards
Enhanced Recovery After Surgery* / standards
Humans
Pain, Postoperative / drug therapy*
Pain, Postoperative / therapy
Patient Care Bundles* / economics
Patient Care Bundles* / standards
Perioperative Care / economics
Perioperative Care / standards
Postoperative Complications / etiology
Postoperative Complications / prevention & control*
Postoperative Complications / therapy