Enhanced recovery pathways in gynecology

Abstract

Objective: Enhanced recovery after surgery (ERAS) is a multimodal approach to improving outcomes surrounding perioperative care. Recommendations are regulation of intake fluids and foods, nausea, vomiting management and encouraging a regular diet, and early mobilization. In this article, ERAS rules and regulations for better perioperative outcome and comfort are discussed.Materials and Methods: This article discusses major reviews and recommendations of medical societies for ERAS.Results: Prompt removal of drains, catheters, and lines and using laxatives on routine basis are inevitable landmarks of ERAS protocol. Hypothermia, decreased perfusion of peripheral organs, fluid and electrolyte imbalances, and insulin resistance all can lead to the release of counter regulatory hormones, including cortisol, growth hormone, glucagon, and catecholamines. Hormonal changes around surgery can trigger the release of inflammatory cytokines that eventually may lead to adverse outcomes.Conclusions: The main goal of ERAS is to prevent and decrease this negative cascade in the context of perioperative care.