Anesthetists play a critical role in ERAS programs for VATS lobectomy through tailored anesthetic plans, protective one-lung ventilation, and opioid-sparing multimodal analgesia to promote fast recovery.
May inform ERAS anesthesia for VATS lobectomy; leaves open RCTs to confirm outcomes.
Enhanced recovery after surgery (ERAS) programs are developed to prevent factors that delay postoperative recovery as well as issues that cause complications. The development of video-assist thoracoscopic surgery (VATS) techniques favors the fast recovery after thoracic procedures. ERAS strategies are based on multidisciplinary approach in which the anesthetist plays an important role from the preoperative to the postoperative phase with several goals. After preoperative evaluation and medical optimization, the anesthetist must ensure a tailored anesthetic plan aiming to a fast recovery and adequate pain relief to reduce the response to the surgical stress. The present narrative review presents the major parts of the ERAS anesthetic approach to VATS lobectomy like short-acting drugs, protective one-lung ventilation (OLV), fluid administration and opioid-sparing multimodal analgesia.
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Piccioni et al. (2018) studied this question.
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