Abstract: |
Enhanced recovery pathways (ERP) are focused on improving perioperative patient care to reduce postoperative complications and improve outcomes. ERP includes elements of preoperative preparation, fluid management, anesthesia and analgesia, and perioperative nutrition and mobilization. Significant evidence suggests that traditional non-evidence-based perioperative nutritional and fluid management dogmas that prolong fasting and promote fluid overload should be abandoned. Carbohydrate loading has been shown to be safe in non-diabetic patients while also reducing postoperative insulin resistance. Evidence suggest that perioperative fluid overload and restriction should be avoided, and near-zero homeostasis should be the goal of perioperative fluid management. Goal-directed fluid therapy (GDFT) has shown to be safe in most patients and could be beneficial in high-risk patients. © 2021 Elsevier Inc. |