Anesthesia and Enhanced Recovery After Head and Neck Surgery

Otolaryngol Clin North Am. 2019 Dec;52(6):1095-1114. doi: 10.1016/j.otc.2019.08.008. Epub 2019 Sep 21.

Abstract

Enhanced recovery protocols have been developed from gastrointestinal, colorectal, and thoracic surgery populations. The basic tenets of head and neck enhanced recovery are: a multidisciplinary team working around the patient, preoperative carbohydrate loading, multimodal analgesia, early mobilization and oral feeding, and frequent reassessment and auditing of protocols to improve patient outcomes. The implementation of enhanced recovery protocols across surgical populations appear to decrease length of stay, reduce cost, and improve patient satisfaction without sacrificing patient quality of care or changing readmission rates. This article examines evidence-based enhanced recovery interventions and tailors them to a major head and neck surgery population.

Keywords: Cost; Enhanced recovery; Evidence-based medicine; Fast track surgery; Length of stay; Major head and neck surgery; Preoperative carbohydrate loading; Surgical outcomes.

Publication types

  • Review

MeSH terms

  • Anesthesia*
  • Evidence-Based Medicine
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Length of Stay / economics
  • Nutritional Support
  • Patient Satisfaction
  • Perioperative Care*
  • Plastic Surgery Procedures*
  • Postoperative Complications / prevention & control
  • Practice Guidelines as Topic
  • Randomized Controlled Trials as Topic