The role of the anesthesiologist in fast-track surgery: From multimodal analgesia to perioperative medical care

Paul F. White, Henrik Kehlet, Joseph M. Neal, Thomas Schricker, Daniel B. Carr, Franco Carli, Frances Chung, Gerald M. Fried, Nancy E. Mayo, Anthony J. Senagore, Daniel I. Sessler, Douglas Wilmore, Gerald S. Zavorsky

Research output: Contribution to journalReview article

279 Scopus citations

Abstract

BACKGROUND: Improving perioperative efficiency and throughput has become increasingly important in the modern practice of anesthesiology. Fast-track surgery represents a multidisciplinary approach to improving perioperative efficiency by facilitating recovery after both minor (i.e., outpatient) and major (inpatient) surgery procedures. In this article we focus on the expanding role of the anesthesiologist in fast-track surgery. METHODS: A multidisciplinary group of clinical investigators met at McGill University in the Fall of 2005 to discuss current anesthetic and surgical practices directed at improving the postoperative recovery process. A subgroup of the attendees at this conference was assigned the task of reviewing the peer-reviewed literature on this topic as it related to the role of the anesthesiologist as a perioperative physician. RESULTS: Anesthesiologists as perioperative physicians play a key role in fast-track surgery through their choice of preoperative medication, anesthetics and techniques, use of prophylactic drugs to minimize side effects (e.g., pain, nausea and vomiting, dizziness), as well as the administration of adjunctive drugs to maintain major organ system function during and after surgery. CONCLUSION: The decisions of the anesthesiologist as a key perioperative physician are of critical importance to the surgical care team in developing a successful fast-track surgery program.

Original languageEnglish (US)
Pages (from-to)1380-1396
Number of pages17
JournalAnesthesia and Analgesia
Volume104
Issue number6
DOIs
StatePublished - Jun 2007
Externally publishedYes

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ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

White, P. F., Kehlet, H., Neal, J. M., Schricker, T., Carr, D. B., Carli, F., Chung, F., Fried, G. M., Mayo, N. E., Senagore, A. J., Sessler, D. I., Wilmore, D., & Zavorsky, G. S. (2007). The role of the anesthesiologist in fast-track surgery: From multimodal analgesia to perioperative medical care. Anesthesia and Analgesia, 104(6), 1380-1396. https://doi.org/10.1213/01.ane.0000263034.96885.e1