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Abstract Despite steady advances in anaesthetic and surgical techniques over the years, post-operative complications remain one of the major drawbacks of surgery, not only for the specific patient involved but also for their surgical care team and the health care system in general. Rarely do patients die on the operating table during the surgical procedure, but rather from the pathophysiological response to surgery and its complications. The progressive understanding of the physiological basis of surgical injury has been the rationale underpinning the research efforts of interdisciplinary teams, incorporating surgeons and anaesthesiologists to minimize the surgical stress response and thereby improve outcomes. However, one of the immediate challenges to improve the quality of perioperative care is not to discover new knowledge, but rather to integrate what we already know into clinical practice. To this end, the concept of “fast-track surgery” was introduced. “Fast-track” or “enhanced recovery after surgery” (ERAS) clinical pathways have been proposed to improve the quality of perioperative care with the aim of attenuating the loss of functional capacity and accelerating the recovery process. Compared with traditional perioperative care, the Enhanced Recovery After Surgery (ERAS) programme represents a fundamental shift in the process of care, by including multiple interventions that attenuate surgical stress, maintain physiological function and expedite return to baseline. While each intervention has a small effect, all together they have a stronger synergistic impact. |