Piccioni Federico, Ragazzi Riccardo
Department of Critical Care Medicine and Support Therapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Department of Morphology, Surgery and Experimental Medicine, Azienda Ospedaliero-Universitaria Sant'Anna, Ferrara, Italy.
J Vis Surg. 2018 Jan 11;4:9. doi: 10.21037/jovs.2017.12.11. eCollection 2018.
Enhanced recovery after surgery (ERAS) programs are developed to prevent factors that delay postoperative recovery as well as issues that cause complications. The development of video-assist thoracoscopic surgery (VATS) techniques favors the fast recovery after thoracic procedures. ERAS strategies are based on multidisciplinary approach in which the anesthetist plays an important role from the preoperative to the postoperative phase with several goals. After preoperative evaluation and medical optimization, the anesthetist must ensure a tailored anesthetic plan aiming to a fast recovery and adequate pain relief to reduce the response to the surgical stress. The present narrative review presents the major parts of the ERAS anesthetic approach to VATS lobectomy like short-acting drugs, protective one-lung ventilation (OLV), fluid administration and opioid-sparing multimodal analgesia.
术后加速康复（ERAS）计划旨在预防延迟术后康复的因素以及引发并发症的问题。电视辅助胸腔镜手术（VATS）技术的发展有利于胸部手术后的快速康复。ERAS策略基于多学科方法，麻醉医生在术前到术后阶段发挥着重要作用，有多个目标。经过术前评估和医疗优化后，麻醉医生必须确保制定个性化的麻醉计划，目标是快速康复和充分缓解疼痛，以减轻对手术应激的反应。本叙述性综述介绍了ERAS麻醉方法用于VATS肺叶切除术的主要部分，如短效药物、保护性单肺通气（OLV）、液体管理和阿片类药物节省的多模式镇痛。
