Brief Article
Copyright ©2013 Baishideng Publishing Group Co.
World J Gastroenterol. Jun 21, 2013; 19(23): 3642-3648
Published online Jun 21, 2013. doi: 10.3748/wjg.v19.i23.3642
Table 1 Comparison of fast-track surgery and conventional perioperative intervention protocols
Perioperative interventionConventionalFast-track surgery
Diet before surgeryNo intake of food and drink after supper the day before surgeryIntake of 1000 mL 14% carbohydrate drink 12 h before and 350 mL 14% carbohydrate drink 3 h before surgery.
AnesthesiaTracheal intubation and general anesthesiaTracheal intubation and general anesthesia
Thermal insulation during operationNo thermal insulation, room temperature was maintained at 22  °CThermal insulation of the body and extremities, body temperature was maintained at 36  °C
Operation procedureStandard laparotomy approachStandard laparotomy approach
Placement of abdominal drainageUse of abdominal drainage tubeNo routine use of abdominal drainage tube
Analgesia after operationStandard use of patient-controlled analgesic pumpInfiltration of surgical wounds with ropivacaine at the end of surgery and 24 h after surgery. Oral intake of 200 mg celecoxib twice daily
Mobilization after operationMobilize out of bed on patients’ own requestEncourage patients to mobilize out of bed
Diet after operationOral intake initiated after flatus (following a stepwise plan from water to other liquids to semi-fluids to normal food)Oral intake of 500-1000 mL glucose saline on the day of surgery. Intake of 2000-3000 mL liquid food containing 1000 kcal to 1200 kcal per day from the 1st day after surgery
Intravenous nutrition after operationInfusion of glucose saline and amino acid injection iv on the day of surgery. Infusion of parenteral nutrition (25 kcal/kg of body weight) iv before oral intake. Appropriate level of iv fluid intake based on the volume of liquid intake and output, and physiological needInfusion of parenteral nutrition iv if oral intake is not adequate. Appropriate level of iv fluid intake based on the volume of liquid intake and output, and physiological need
Removal of nasogastric tubeRemoval of nasogastric tube after flatusRemoval of nasogastric tube within 24 h after surgery
Removal of urine catheterRemoval of urine catheter on the 3rd or 4th day after surgeryRemoval of urine catheter within 24 h after surgery
AntibioticsStandard use of antibiotics for 3 d after surgeryStandard use of antibiotics before and once after surgery