Department of Surgery, Kansai Medical University, Hirakata, Osaka, Japan.
Department of Gastroenterological Surgery, Iwate Prefectural Central Hospital, Morioka, Japan.
Asian J Surg. 2020 Jan;43(1):124-129. doi: 10.1016/j.asjsur.2019.02.007. Epub 2019 Mar 13.
In 2012, the Japanese Society for Surgical Metabolism and Nutrition introduced the Essential Strategy for Early Normalization after Surgery with Patient's Excellent Satisfaction (ESSENSE) program to improve the perioperative management of gastrointestinal surgery. The ESSENSE program aimed to minimize ineffective perioperative management practices, and achieve adequate analgesia to expedite the return to work and activities of daily living.
After educating relevant facilities about the ESSENSE program in 2012, we conducted questionnaire-based surveys in selected institutions in 2013 and 2016.
ESSENSE was implemented in 65% of the specified gastrointestinal surgical procedures in 2016. Oral fluids were discontinued >10 h before anesthesia induction by 33% and 9% of respondents in 2013 and 2016, respectively, and 2 h before anesthesia induction by 23% and 38% in 2013 and 2016, respectively. Fasting was initiated >10 h before anesthesia induction by 75% and 29% of respondents in 2013 and 2016, respectively, and 6-8 h before anesthesia induction by 20% and 60% in 2013 and 2016, respectively. Oral rehydration with a carbohydrate-containing beverage was performed 2 h preoperatively by 23% and 47% of respondents in 2013 and 2016, respectively. The median postoperative periods after which water and solids intakes were resumed were significantly shorter in 2016 than in 2013 after five surgical procedures; the exceptions were esophagectomy, laparoscopic cholecystectomy, and hepatectomy.
There was a high level of implementation of the ESSENSE program in participating institutions in 2016, suggesting that it is possible to achieve widespread implementation of a preoperative management protocol.
2012 年，日本外科代谢与营养学会提出了《手术患者满意度的早期正常化基本策略》（ESSENSE）计划，以改善胃肠外科的围手术期管理。ESSENSE 计划旨在减少无效的围手术期管理措施，并实现充分的镇痛，以加快患者重返工作和日常生活的速度。
2012 年对相关医疗机构进行 ESSENSE 计划教育后，我们于 2013 年和 2016 年在选定的机构进行了基于问卷调查的调查。
2016 年，指定的胃肠外科手术中有 65%实施了 ESSENSE。2013 年和 2016 年，分别有 33%和 9%的受访者在麻醉诱导前 10 小时以上停止口服液体，23%和 38%的受访者在麻醉诱导前 2 小时停止口服液体；分别有 75%和 29%的受访者在麻醉诱导前 10 小时以上开始禁食，20%和 60%的受访者在麻醉诱导前 6-8 小时开始禁食。2013 年和 2016 年，分别有 23%和 47%的受访者在术前 2 小时进行含碳水化合物的口服补液。5 种手术后，水和固体摄入恢复的术后中位时间在 2016 年明显短于 2013 年；食管切除术、腹腔镜胆囊切除术和肝切除术除外。
2016 年参与机构对 ESSENSE 计划的实施水平较高，表明有可能实现术前管理方案的广泛实施。
