Department of Anaesthesia, Stony Brook University School of Medicine, Stony Brook, New York, USA.
Anaesthesia. 2016 Jan;71 Suppl 1:40-5. doi: 10.1111/anae.13309.
'Enhanced recovery after surgery' protocols implement a series of peri-operative interventions intended to improve recovery after major operations, one aspect of which is fluid management. The pre-operative goal is to prepare a hydrated, euvolaemic patient by avoiding routine mechanical bowel preparation and by encouraging patients to drink clear liquids up to two hours before induction of anaesthesia. The intra-operative goal is to achieve a 'zero' fluid balance at the end of uncomplicated surgery: goal-directed fluid therapy is recommended for poorly prepared or sick patients or those undergoing more complex surgery. The postoperative goal is eating and drinking without intravenous fluid infusions. Postoperative oliguria should be expected and accepted, as urine output does not indicate overall fluid status.
“术后加速康复”方案实施了一系列围手术期干预措施，旨在改善大手术后的恢复情况，其中一个方面是液体管理。术前的目标是通过避免常规机械肠道准备和鼓励患者在麻醉诱导前两小时内饮用清亮液体来使患者处于水合、血容量正常的状态。术中的目标是在简单手术结束时实现“零”液体平衡：对于准备不佳或患病的患者，或接受更复杂手术的患者，建议进行目标导向的液体治疗。术后的目标是无需静脉输液即可进食和饮水。术后少尿应预期并接受，因为尿量并不能指示总体液体状态。
