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Ji W, Chandoo A, Guo X, You T, Shao Z, Zheng K, Wang J, Bi J, Smith FG, Tucker ON, Shen X. Enhanced recovery after surgery decreases intestinal recovery time and pain intensity in patients undergoing curative gastrectomy. Cancer Manag Res 2018; 10:3513-3520. [PMID: 30271200 PMCID: PMC6145634 DOI: 10.2147/cmar.s168909] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Background Enhanced recovery after surgery (ERAS) reduces postoperative stress, increases patient satisfaction, and reduces postoperative stay and cost. In this study, we evaluated the feasibility and effectiveness of ERAS protocols compared with conventional perioperative care group and their effect in gastric cancer patients undergoing gastrectomy. Methods A cohort of 366 patients were analyzed from a prospectively maintained database. The patients’ characteristics, tumor profile, surgical information data and postoperative complications were evaluated. Results Patients in the ERAS had a faster gastrointestinal function recovery and first flatus (3.26±0.64; P<0.001). Pain intensity of patients in the ERAS group was significantly lower than that of patients in the conventional care group on postoperative days 1 (2.33±0.98; P<0.001) and 3 (1.06±0.63; P<0.001). Postoperative hospital stays were significantly shorter in patients receiving ERAS program (6.66±3.36; P<0.001), than in those patients who received conventional perioperative care (9.02±2.61). Conclusion ERAS can reduce postoperative stress, enhance the recovery of the gut, reduce the pain intensity, and increase satisfaction in gastric cancer patient undergoing curative gastrectomy.
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Affiliation(s)
- Weiping Ji
- Department of General Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, People's Republic of China, , .,Department of General Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China, .,Institute of Inflammation and Dental Sciences, University of Birmingham, Birmingham, UK,
| | - Arvine Chandoo
- Department of General Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, People's Republic of China, ,
| | - Xiaoling Guo
- Department of General Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, People's Republic of China, ,
| | - Tao You
- Department of General Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, People's Republic of China, ,
| | - Zhuo Shao
- Department of General Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China,
| | - Kailian Zheng
- Department of General Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China,
| | - Juan Wang
- Department of General Surgery, Xi Jing Hospital, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Jianwei Bi
- Department of General Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China,
| | - Fang Gao Smith
- Institute of Inflammation and Dental Sciences, University of Birmingham, Birmingham, UK,
| | - Olga N Tucker
- Department of Upper Gastrointestinal Surgery, Heart of England NHS Foundation Trust, Birmingham, UK
| | - Xian Shen
- Department of General Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, People's Republic of China, ,
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Tornero Tornero C, Fernández Rodríguez LE, Orduña Valls J. Multimodal analgesia and regional anaesthesia. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2017; 64:401-405. [PMID: 28347551 DOI: 10.1016/j.redar.2017.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 01/28/2017] [Indexed: 12/20/2022]
Abstract
Multimodal analgesia provides quality analgesia, with fewer side effects due to the use of combined analgesics or analgesic techniques. Regional anaesthesia plays a fundamental role in achieving this goal. The different techniques of regional anaesthesia that include both peripheral and central blocks in either a single dose or in continuous infusion help to modulate the nociceptive stimuli that access the central level. The emergence of the ultrasound as an effective system to perform regional anaesthesia techniques has allowed the development of new regional anaesthesia techniques that formerly could not be carried out since only neurostimulation or skin references were used. It is essential to take into account that even with effective blocking it is advisable to associate other drugs by other routes, in this way we will be able to reduce the required doses individually and attempt to achieve a synergistic, not purely additive, effect.
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Affiliation(s)
- C Tornero Tornero
- Unidad del Dolor, Servicio de Anestesiología, Hospital Clínico Universitario de Valencia, Valencia, España; Departamento de Anatomía Humana, Universitat de Valencia, Valencia, España.
| | - L E Fernández Rodríguez
- Servicio de Anestesiología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - J Orduña Valls
- Unidad del Dolor, Servicio de Anestesiología, Hospital Clínico Universitario de Valencia, Valencia, España
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Qu G, Cui XL, Liu HJ, Ji ZG, Huang YG. Ultrasound-guided Transversus Abdominis Plane Block Improves Postoperative Analgesia and Early Recovery in Patients Undergoing Retroperitoneoscopic Urologic Surgeries: A Randomized Controlled Double-blinded Trial. ACTA ACUST UNITED AC 2016; 31:137-141. [DOI: 10.1016/s1001-9294(16)30041-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hamill JK, Liley A, Hill AG. Rectus sheath block for laparoscopic appendicectomy: a randomized clinical trial. ANZ J Surg 2015; 85:951-6. [DOI: 10.1111/ans.12950] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2014] [Indexed: 12/19/2022]
Affiliation(s)
- James K. Hamill
- Department of Paediatric Surgery; Starship Children's Hospital; Auckland New Zealand
- Department of Surgery; Faculty of Medical and Health Sciences; University of Auckland; Auckland New Zealand
| | - Andrew Liley
- Department of Anaesthesia; Starship Children's Hospital; Auckland New Zealand
| | - Andrew G. Hill
- Faculty of Medical and Health Sciences; South Auckland Clinical School; School of Medicine; University of Auckland; Auckland New Zealand
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