title: Clinical strategies to accelerate recovery after surgery orthopedic femur in elderly patients.
abstract: BACKGROUND
  The prevalence of hip fracture is increasing with the continued aging of the population. The aim of this study was to compare the results after implementing the project accelerated post-operative recovery after surgery femur in patients aged over 60 years.
  
  
  METHODS
  Patients were observed during two distinct periods: Before implantation and after the implementation of the project Acerto. Patients underwent spinal anesthesia with post-operative analgesia by lumbar plexus block. Data evaluation was carried out in four stages of the study in both groups: Before arrival to the operating room during surgery, post-anesthesia care unit and on the ward in the morning of day 1 post-operatively.
  
  
  RESULTS
  The project implementation significantly reduces the length of stay, the number of suspension of surgery, duration of fasting, the incidence of hunger and thirst and the reintroduction of oral feeding. Oral feeding 2-4 h before surgery with dextrinomaltose not attended with nausea and vomiting. All patients were able to discharge on day 1 post-operatively.
  
  
  CONCLUSIONS
  The use of clinical measures of accelerating patient recovery decreased length of stay, the number of suspensions of surgery, the time of fasting, the time of oral food reintroduction, high earlier and faster return to family life, working as humanization of treatment to the elderly.
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Nova Esperança, João Pessoa, PB, Brazil ; Institute for Regional Anesthesia, João Pessoa, PB, Brazil.
authors.forename: Luiz Eduardo
authors.initials: LE
authors.lastname: Imbelloni
authors.affiliation: Nutritionist Specializing in Public Health, João Pessoa, PB, Brazil ; Head of Nutrition Complexo Hospitalar Mangabeira, João Pessoa, PB, Brazil.
authors.forename: Danielly
authors.initials: D
authors.lastname: Gomes
authors.affiliation: Nurse with Specialization in the Intensive Care Unit, João Pessoa, PB, Brazil ; Nurse Surgical Center Complexo Hospitalar Mangabeira, João Pessoa, PB, Brazil.
authors.forename: Rafaela Lopes
authors.initials: RL
authors.lastname: Braga
authors.affiliation: UFPB, João Pessoa, PB, Brazil ; Statistician of the Complexo Hospitalar Mangabeira, João Pessoa, PB, Brazil.
authors.forename: Geraldo Borges
authors.initials: GB
authors.lastname: de Morais Filho
authors.affiliation: Technical Nursing from the School of Nursing Santa Emilia de Rodat, João Pessoa, PB, Brazil ; Technical Nursing Center Surgical Complexo Hospitalar Mangabeira, João Pessoa, PB, Brazil.
authors.forename: Alberto
authors.initials: A
authors.lastname: da Silva
keywords: Fasting; fast-track surgery; orthopedic; perioperative care; spinal anesthesia; surgery