Universität zu Köln

Standl, T. (2021). The modern Fast Track Concept 2.0. Anasthesiol. Intensivmed., 62. S. 452 - 463. EBELSBACH: AKTIV DRUCK & VERLAG GMBH. ISSN 1439-0256

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Abstract

The modern Fast track concept 2.0 is based on 20 years of experience and positive results in colorectal Fast track Surgery, consisting of reduced bowel preparation, minimally invasive surgery and thoracic epidural analgesia (TEA) as its cornerstones. Further developments contributing to Fast track 2.0 concepts included an active role of the patient and continuous perioperative assistance by fast track assistants, especially in terms of perioperative enteral nutrition and mobilisation. Preservation of patients' metabolic balance allows for a restrictive intraoperative fluid regimen, which is beneficial for postoperative bowel function. Laparoscopic surgery, no drainage and removal of tubes and catheters on the first postoperative day are part of Fast track concept 2.0 as well as a standardised anaesthetic protocol. The latter consists of prevention of nausea and vomiting, optimised anaesthesia and muscle relaxation, as well as maintenance of normothermia und euvolaemia. Multimodal analgesia comprises oral analgesics as well as techniques based on local anaesthetics such as TEA, lidocaine IV or wound infusion and bilateral TAP blocks. Numerous studies have shown that the standardised Fast track concept 2.0 improved bowel function and reduced postoperative morbidity and hospitalisation. The concept will be extended to additional surgical indications and more disciplines in the near future.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Standl, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-566873
DOI:	10.19224/ai2021.452
Journal or Publication Title:	Anasthesiol. Intensivmed.
Volume:	62
Page Range:	S. 452 - 463
Date:	2021
Publisher:	AKTIV DRUCK & VERLAG GMBH
Place of Publication:	EBELSBACH
ISSN:	1439-0256
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RESIDUAL NEUROMUSCULAR BLOCKADE; SURGICAL SPACE CONDITIONS; ENHANCED RECOVERY; EPIDURAL ANALGESIA; COLORECTAL SURGERY; CATHETER; DEEP; METAANALYSIS; NEOSTIGMINE; ANESTHESIA Multiple languages Anesthesiology; Critical Care Medicine Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/56687