title: Pathophysiology of major surgery and the role of enhanced recovery pathways and the anesthesiologist to improve outcomes.
abstract: Enhanced recovery pathways have been increasingly adopted into surgical specialties with the aim of reducing the stress response and improving the metabolic response to surgical insult. Enhanced recovery pathways encompass a large range of perioperative elements that together aim to restore a patient's gut function, mobility, function and well-being to preoperative levels as soon as feasible after major surgery. There is increasing evidence that rapid recovery and return to normal function reduces complications. This may not just have a benefit by reducing morbidity and mortality but also have an effect on long-term survival. There also may be additional benefits for patients with cancer.
authors.affiliation: Department of Anesthesia and Perioperative Medicine, Royal Surrey County Hospital NHS Foundation Trust, Egerton Road, Surrey, Guildford GU1 7XX, United Kingdom; Surrey Perioperative Anesthesia Critical Care Research Group (SPACeR), University of Surrey, Surrey, Guildford GU2 7XH, United Kingdom. Electronic address: mjpscott@btinternet.com.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Scott
authors.affiliation: Department of Anesthesiology, Duke University Medical Center, BOX 3094, HAFS 5677, Durham, NC 27710, USA.
authors.forename: Timothy E
authors.initials: TE
authors.lastname: Miller
mesh_terms: D000776:Anesthesiology / Q000379:methods*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D013312:Stress, Physiological; D013514:Surgical Procedures, Operative / Q000009:adverse effects*
keywords: Anesthesia; Enhanced recovery pathway; Fast-track surgery; Metabolic response to surgery; Minimally invasive surgery; Pathophysiology of surgery; Perioperative care; Stress response to surgery