加速康复外科在麻醉医学中的应用与展望

Enhanced Recovery after Surgery: History and Future Development

加速康复外科(enhanced recovery after surgery,ERAS)是指采用有循证医学证据的一系列多模式围术期优化措施,以阻断或减轻机体应激反应为目的,最终促进患者术后尽快康复。目前,ERAS已经在胃肠道手术、泌尿系统手术、胰腺手术、妇产科手术、减重手术等多种手术类型中广泛应用,其效果已经被越来越多的研究结果证实。近年来ERAS理念成为推动围术期多学科协作管理的核心,其在围术期疼痛管理中的作用也越来越突出。随着ERAS的发展,麻醉医学也逐渐向围术期医学转变。ERAS强调多学科合作,麻醉医师在术前评估优化、围术期管理及改善患者远期预后方面,均起到了至关重要的作用。

Enhanced recovery after surgery （ERAS） is a multimodal pathway developed to overcome the deleterious effect of perioperative stress after major surgery and enhance recovery.It has been successfully implemented in various types of surgical procedures and favored by increasing amount of research data.Together with the development of ERAS, anesthesia has transformed to perioperative medicine.As key member of the multidisciplinary management team in ERAS programs, anesthesiologists play important role in not only preoperative risk stratification and optimization, but also enhanced long-term recovery.