Fellow, Surgical Critical Care, Department of Anesthesiology and Critical Care, Penn Medicine, 6 Dulles, 3400 Spruce Street, Philadelphia, PA 19104, USA; Anesthesiologist & Intensivist, Department of Anesthesiology, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA.
Anesthesiol Clin. 2022 Mar;40(1):119-142. doi: 10.1016/j.anclin.2021.11.006. Epub 2022 Feb 11.
The Enhanced Recovery After Surgery Society published guidelines for bariatric surgery reviewing the evidence and providing specific care recommendations. These guidelines emphasize preoperative nutrition, multimodal analgesia, postoperative nausea and vomiting prophylaxis, anesthetic technique, nutrition, and mobilization. Several studies have since evaluated these pathways, showing them to be safe and effective at decreasing hospital length of stay and postoperative nausea and vomiting. This article emphasizes anesthetic management in the perioperative period and outlines future directions, including the application of Enhanced Recovery After Surgery principles in patients with extreme obesity, diabetes, and metabolic disease and standardization of the pathways to decrease heterogeneity.
《术后恢复加速康复外科协会》发布了肥胖症手术治疗指南，对现有证据进行了回顾并提出了具体的围术期处理建议。这些指南强调了术前营养、多模式镇痛、术后恶心呕吐预防、麻醉技术、营养和运动等内容。此后，多项研究对这些路径进行了评估，证明其可安全有效地减少住院时间和术后恶心呕吐的发生。本文重点介绍围手术期的麻醉管理，并概述了未来的发展方向，包括将加速康复外科原则应用于极度肥胖、糖尿病和代谢性疾病患者，以及对这些路径进行标准化以减少异质性。
