RESUMEN
The Enhanced Recovery After Surgery Society published guidelines for bariatric surgery reviewing the evidence and providing specific care recommendations. These guidelines emphasize preoperative nutrition, multimodal analgesia, postoperative nausea and vomiting prophylaxis, anesthetic technique, nutrition, and mobilization. Several studies have since evaluated these pathways, showing them to be safe and effective at decreasing hospital length of stay and postoperative nausea and vomiting. This article emphasizes anesthetic management in the perioperative period and outlines future directions, including the application of Enhanced Recovery After Surgery principles in patients with extreme obesity, diabetes, and metabolic disease and standardization of the pathways to decrease heterogeneity.
Asunto(s)
Anestesia , Anestésicos , Cirugía Bariátrica , Recuperación Mejorada Después de la Cirugía , Cirugía Bariátrica/métodos , Humanos , Náusea y Vómito Posoperatorios/prevención & controlRESUMEN
Point-of-care ultrasound is becoming increasingly utilized in centers throughout the country for use in perioperative regional anesthesia procedures, vascular access, diagnosis, and resuscitation. We propose an educational approach that not only spans the 4-year duration of anesthesia residency but also regularly assesses progress throughout training. We accomplish this through a flipped classroom model, in which the 12 residents in each class participate in online modules for the baseline didactic knowledge, then come to a session where they have the opportunity to work in small groups (1:2-1:3 ratio of faculty to learner) and practice the skills outlined in the modules.