Postoperative
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Optimal analgesia w/ minimal side effects (opioid-sparing strategies)
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Regional anesthesia
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Thoracic epidural (T6-T11): gold standard in open abdominal surgery
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TAP blocks, continuous wound infusion
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Multimodal regimens
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NSAIDs, acetaminophen
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IV lidocaine infusion
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Consider gabapentinoids, IV ketamine, high-dose steroids
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Postop delirium
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Prevention: avoid prolonged fasting, deep anesthesia, delirogenic rx; maintain sleep-wake cycle
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Systematic delirium screening
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Symptom-oriented treatment
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Rule out potential underlying medical causes
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Postop ileus: Multimodal prevention strategies
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Laparoscopic if possible
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TEA, opioid-sparing strategies
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Avoid excess fluid, mobilization, early feeding/gum chewing, no prophylactic NGT
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Early mobilization
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Multidisciplinary approach
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Daily targets & recording of physical activity
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Adapted from Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 2: consensus statement for anaesthesia practice. Acta Anaesthesiologica Scandinavica 60 (2016) 289–334