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Anesth Analg ; 128(6): 1107-1117, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31094775

RESUMO

Enhanced recovery after surgery (ERAS) protocols represent patient-centered, evidence-based, multidisciplinary care of the surgical patient. Although these patterns have been validated in numerous surgical specialities, ERAS has not been widely described for patients undergoing hip fracture (HFx) repair. As part of the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery, we have conducted a full evidence review of interventions that form the basis of the anesthesia components of the ERAS HFx pathway. A literature search was performed for each protocol component, and the highest levels of evidence available were selected for review. Anesthesiology components of care were identified and evaluated across the perioperative continuum. For the preoperative phase, the use of regional analgesia and nonopioid multimodal analgesic agents is suggested. For the intraoperative phase, a standardized anesthetic with postoperative nausea and vomiting prophylaxis is suggested. For the postoperative phase, a multimodal (primarily nonopioid) analgesic regimen is suggested. A summary of the best available evidence and recommendations for inclusion in ERAS protocols for HFx repair are provided.


Assuntos
Anestesiologia/métodos , Anestesiologia/normas , Artroplastia de Quadril/métodos , Fraturas do Quadril/cirurgia , Analgésicos/uso terapêutico , Anestésicos/efeitos adversos , Anestésicos/uso terapêutico , Medicina Baseada em Evidências , Humanos , Comunicação Interdisciplinar , Bloqueio Nervoso , Manejo da Dor , Segurança do Paciente , Assistência Centrada no Paciente , Assistência Perioperatória/métodos , Período Perioperatório , Ensaios Clínicos Controlados Aleatórios como Assunto , Estados Unidos , United States Agency for Healthcare Research and Quality
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