Moderators: Michael P. Steinmetz, MD, Michael Y. Wang, MD
At a cellular level, every surgery is treated as a disruption of the body’s physiology leading to a neuro-humoral stress response. ERASS was established to improve outcomes after colorectal surgery. It was designed to “cheat” the body of its stress response by a series of interventions.
These multimodal interventions begin from the time of consultation for surgical scheduling to post discharge. Early mobilization, thromboembolism prophylaxis, MIS approaches, opioid based pain management are common practice. Preadmission counselling and education, preoperative carbohydrate loading, standardized anesthetic methods, epidural analgesia, perioperative fluid management, insulin resistance are often disregarded.
Faculty will discuss various ERASS protocols, their physiologic importance, preoperative optimization, nonnarcotic pain management, optimal monitoring in patients with goal directed fluid management, checklist for patients with specific goals, Ileus management, and finally pathway to setup a multidisciplinary team. In addition, faculty will describe various strategies for ambulatory care centers to manage same day surgery in coordination with insurance companies.
Upon completion of this session, participants should gain strategies to:
- Identify ERASS concepts
- Recognize important physiological responses to surgery and strategies to minimize them
- Distinguish anesthesia protocols to minimize redundancy
- Know preoperative counseling and create target check list for patient involved tasks
- Use perioperative fluid management and monitor tailored interventions
- Discern pain and minimize narcotic consumption
- Implementing an ERAS program at their institution
- Be familiar with data management and outcomes analysis
Agenda
Introduction to Concepts of Enhanced Recovery After Spine Surgery
Michael Y. Wang, MD
Neurohumoral Response to Surgery and Perioperative Fluid and Nutrition Management
Karthik Madhavan, MD
Preoperative Considerations for Adult Deformity Surgery
Christopher I. Shaffrey, MD
Role of Anesthesia in Minimizing Redundancy
Ajit A. Krishnaney, MD
Perioperative Pain Management with Non-Narcotic Analgesia
Christoph P. Hofstetter, MD, PhD
Perioperative Blood Management
Michael P. Steinmetz, MD
Role of Minimally Invasive Surgery in ERASS
Sheeraz A. Qureshi, MD, MBA
The Role of Physical Therapy on Same Day Mobilization
Matthew Smuck, MD
Role of Advanced Practice Provider: Preoperative and Post Discharge Counselling to Minimize Hospital Visits
Erin Anderson, PAC
Discussion, Questions and Answers
Faculty Panel