title: Evidence-based anesthesia for major gynecologic surgery.
abstract: Studies on enhanced recovery after gynecological surgery are limited but seem to report outcome benefits similar to those reported after colorectal surgery. Regional anesthesia is recommended in enhanced recovery protocols. Effective regional anesthetic techniques in gynecologic surgery include spinal anesthesia, epidural analgesia, transversus abdominis plane blocks, local anesthetic wound infusions and intraperitoneal instillation catheters. Non-opioid analgesics including pregabalin, gabapentin, NSAIDs, COX-2 inhibitors, and paracetamol reduce opioid consumption after surgery. This population is at high risk for PONV, thus, a multimodal anti-emetic strategy must be employed, including strategies to reduce the baseline risk of PONV in conjunction with combination antiemetic therapy.
authors.affiliation: Northwestern University, Feinberg School of Medicine, 250 East Huron Street, F5-704, Chicago, IL 60611, USA.
authors.forename: Jeanette R
authors.initials: JR
authors.lastname: Bauchat
authors.affiliation: Duke University Medical Center, Box 3094, Durham, NC 27710, USA. Electronic address: ashraf.habib@duke.edu.
authors.forename: Ashraf S
authors.initials: AS
authors.lastname: Habib
mesh_terms: D000758:Anesthesia; D000776:Anesthesiology / Q000379:methods*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans
keywords: ERAS; Enhanced recovery; Fast track; Gynecologic surgery