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Fast-track surgery for colonic and rectal resections in Austria – Results from a survey on the perioperative anaesthesia management

"Fast-Track"-Chirurgie im Rahmen kolorektaler Resektionen in Österreich – Umfrage zum perioperativen anästhesiologischen Management

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Zusammenfassung

GRUNDLAGEN: Die "Fast-Track"-Rehabilitation im Rahmen elektiver kolorektaler Resektionen ist ein multimodales, perioperatives Behandlungskonzept, das chirurgische und anästhesiologische Aspekte kombiniert. Dadurch wird die Rate allgemeiner Komplikationen vermindert und eine rasche Rekonvaleszenz ermöglicht. Die hier vorgestellte Umfrage untersucht die Verbreitung und die Anwendung dieses Konzeptes in Österreich. METHODIK: 120 anästhesiologische Abteilungen erhielten einen Fragebogen, in dem das übliche anästhesiologische Vorgehen am Beispiel einer elektiven, offenen Sigma- und Rektumresektion beschrieben werden sollte. ERGEBNISSE: Die Rücklaufrate betrug 76 (63 %). Eine Prophylaxe gegen postoperative Übelkeit und Erbrechen ("postoperative nausea and vomiting", PONV) führen 32% der Befragten durch. Es nutzen 75 % der anästhesiologischen Abteilungen epidurale Analgesien. Kurzwirksame Analgetika sind weit verbreitet. Maßnahmen zum Erhalt der Normothermie haben sich fest etabliert. SCHLUSSFOLGERUNGEN: In Österreich orientiert sich die anästhesiologische Versorgung im Rahmen elektiver kolorektaler Resektionen in weiten Teilen an den evidenzbasierten Empfehlungen zur "Fast-Track"-Chirurgie.

Summary

BACKGROUND: "Fast-track" rehabilitation can accelerate recovery, reduce general morbidity and decrease hospital stay after elective colorectal surgery. Despite this evidence, there is no information on the acceptance and utilization of these concepts amongst Austrian anaesthesiologist. In addition to that differences between colonic and rectal resections have not been addressed yet. METHODS: A questionnaire concerning perioperative routines in elective, open colonic and rectal resection was sent to the senior anaesthesiologist in 120 Austrian digestive surgical centres. RESULTS: The response rate was 63% (76 centres). Prophylactic measures for postoperative nausea and vomiting (PONV) were administered in 32% of clinics. Epidural analgesia is in use in three-quarters both of the institutions, regardless of the procedure. Short-acting anaesthetics were used for colonic as well as rectal resections. Normothermia is provided by the majority of anaesthetists. CONCLUSIONS: In Austria the anaesthesiological routine after elective colonic and rectal surgery adheres broadly to the evidence-based recommendations for fast-track concepts.

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Authors and Affiliations

  1. Department of Surgery, University Hospital Mannheim, Ruprecht Karls University Heidelberg, Mannheim, Germany

    T. Hasenberg, S. Post & E. Shang

  2. The Austrian Society of Clinical Nutrition, Vienna, Austria

    B. Reibenwein & K. Schindler

  3. Department of General Surgery, University of Vienna, Vienna, Austria

    F. Längle

  4. Department of Anesthesiology and Intensive Care, Charité Campus Mitte and Charité Virchow Klinikum, Charité Universitätsmedizin, Berlin, Germany

    C. Spies

  5. Department for General and Visceral Surgery, Asklepios Clinic Altona, Hamburg, Germany

    W. Schwenk

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  1. T. Hasenberg
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  2. B. Reibenwein
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  3. F. Längle
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  4. K. Schindler
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  5. S. Post
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Correspondence to T. Hasenberg.

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T. Hasenberg and B. Reibenwein: Equally contributing authors

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Hasenberg, T., Reibenwein, B., Längle, F. et al. Fast-track surgery for colonic and rectal resections in Austria – Results from a survey on the perioperative anaesthesia management. Eur Surg 42, 83–90 (2010). https://doi.org/10.1007/s10353-010-0528-z

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