The Application Of Anesthesia Management Based On The Concept Of Fast Track Surgery On Patients Undergoing Gastric Surgery

Background:Fast-track surgery(FTS)concept aims to usea series of evidence-based medicaloptimization measuresfor patients undergoing elective surgeryto effectively avoid or reduce the patients’ stress response,in order to enhance postoperative rehabilitation of patients,while reducing the incidence of postoperative complications and mortality.This concept is particularly useful for abdominal surgery,and requires multidisciplinary collaboration between surgery,anesthesiology and care teams.This multi-modal approach is designed to optimize postoperative rehabilitation of patients and to improve patients’ outcomes through a number of measures.This change has been widely popularized in clinical abroad,and achieved good results,in this process,anesthesiology also played a very important role.Anesthesia management based on the concept of Fast-track surgery throughout the perioperative period,including preadmission information,education and counseling,adjusting preoperative medical treatment of patients,preoperative fasting timechanges and carbohydrate treatment,anesthesia optimization and improvement,and early intervention for postoperative adverse complications.With the continuous progress and development of anesthesia-related technology,anesthesiology in the further promotion of FTS will play an increasingly important rolein clinical disciplines.However,FTS is not widely used in clinical practice in China;most surgeons and anesthesiologists do not understand this concept,only a few large hospitals to carry out research and application,FTS still has a long way to go.In China,the upper digestive system tumors is still the most common malignant tumor and the main cause ofimortality.According to statistics in 2011 the incidence of malignant tumors in China,gastric cancer ranked third in female,ranked second in male.The stomach cancerranked secondin female in China malignant tumor mortality,and ranked third in male.Therefore,it is more practical and challenging to explore the effectiveness,safety and the corresponding mechanism of anesthesia management based on the concept of FTS in the process of gastric cancer.This article describes the application and function of anesthesia management based on the concept of FTSin gastric cancer surgery.Objective:FTS has been widely used in foreign countries,and has developed relatively mature,but in China most surgeons and anesthesiologists has not paid enough attention to it.In order to improve the relevant basic theory,we need further applied to clinical practice,and a large number of random sample controlled study,while we also need to use the evidence-based medical methods to analysisthis initiative objectively and a comprehensive evaluation of this initiative.Therefore,this article aims to discussthe safety and superiority of the anesthesiabased on the concept of FTS versus the traditional anesthesia in the treatment of gastric cancer.Methods:We collected a total of 60 patients with laparoscopic partial gastrectomy or total gastrectomy from August 2016 to December 2016 in NanFang Hospital,from 18 to 65 years old,weight 45-80Kg,the ASA I or hours.Inclusive criteria:①adults have normal menal state age from 18 to 65 years old;② normal liver and kidney function;③did not take any of the drugs that affects the metabolism;④ intended elective.surgery Discharge criteria:① patients with preoperative hypertension,diabetes,intestinal obstruction and severe heart,lung,liver and kidney damage;②patients with central nervous system diseases;③pregnant women and lactation;④has a history of food and drug allergy.These patients were divided into two groups,both of them were used with FTS concept prescribed by the process.30 patients underwent perioperative anesthesia based on FTS(FTS group),and the remaining 30 patients were treated by conventional anesthesia(conventional group).The two groups were observed and the following indicators were counted:thirsty,hungery and anxiety of the patient;the number of cases of regurgitation and aspiration during the course of induction,intraoperative and prolonged extubation.Patients were followed up,asked and statistics of wound pain,press the number of analgesic pump;the first exhaust time,return to normal diet time,the first defecation time;postoperative complications such as digestive system adverse reactions,incision infection,heart and lung complications and other conditions;and patients after hospitalization,hospital costs.Results:The incidence of thirsty,hungcry and anxiety in the FTS group was significantly lower than that in the conventional treatment group.There was no case of regurgitation and aspiration during the induction,operative time and extubation.There was no significant difference iii VAS pain score between the two groups at the same time after operation.However,the number of times of pressing the analgesic pump in the traditional treatment group was higher than that in the FTS group.The first exhaust time and defecation time in the FTS group were significantly earlier than those in the traditional treatment group,and hospital stay and hospital costs wete lower than the traditional treatment group.Based on the FTS concept of anesthesia management can help to enhance the patients’ postoperative rehabilitation and improve the patients’ satisfaction.