Anesthesiology

The study find that the The Agency for Healthcare Research and Quality; in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality; has developed the Safety Program for Improving Surgical Care and Recovery. Therefor We have conducted an evidence review to select anesthetic interventions that positively influence outcomes and facilitate recovery after bariatric surgery.

Anesthetic interventions

A literature search is perform for each intervention; and the highest levels of available evidence are consider. Anesthesiology-related interventions for pre- (carbohydrate loading/fasting, multimodal preanesthetic medications), intra- (standardized intraoperative pathway, regional anesthesia; opioid minimization and multimodal analgesia, protective ventilation strategy, fluid minimization); and postoperative (multimodal analgesia with opioid minimization) phases of care are include.

They have summarized the best available evidence to recommend the anesthetic components of care for enhanced recovery after surgery for bariatric surgery.  Because There is evidence in the literature; and from society guidelines, to support the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery goals for bariatric surgery.

The anesthetic components

Enhanced recovery after surgery (ERAS) pathways have been shows to decrease length of stay (LOS), perioperative morbidity, and costs primarily after colorectal surgical procedures. Therefore The implementation of ERAS pathways for bariatric surgery has many similarities compared to that for colorectal surgery; and systematic reviews (SRs) of bariatric ERAS pathways also indicate that they result in a decrease in LOS; perioperative opioid use; and overall costs.

The Agency for Healthcare Research and Quality (AHRQ); together with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute (AI) for Patient Safety and Quality at Johns Hopkins; because created the Safety Program for Improving Surgical Care and Recovery (ISCR). Therefore The program relies on evidence-based pathways of care to improve outcomes and enhance perioperative care and patient safety including patients undergoing bariatric surgery.

Enhance perioperative care

The ISCR will be implemented in >750 hospitals nationwide over the next 5 years. We have evaluate the evidence for the anesthetic components to be include in the bariatric surgery pathway. Therefore The surgical components will be review and report separately. But The goals of this evidence review are to assess the current best evidence for anesthetic interventions leading to improved outcomes after bariatric surgery and to determine the anesthetic elements of the bariatric surgery protocol.

Two researchers (M.G., C.L.W.) review available bariatric pathways; but extracted data on items include in major bariatric pathways, and presented each item to the group (anesthesiologists and surgeons list as the authors in this article) for consideration. Therefore Individual components in each perioperative phase of care (Table 1); were included for consideration if majority consensus (>50%) from the group was reached.