Fast track surgery - pathophysiological foundations and contemporary use

Abstract

The paper presents the principles of „fast track surgery”. It is a set of multi-level surgical, anesthesiological and nursing activities, aimed at shortening hospital stay while maintaining satisfactory outcomes in terms of early and late complications. These activities rely mainly on organizational changes, as well as the altering of certain set rules which have no contemporary confirmation in evidence-based medicine. These include early ambulation, the use of non-opioid pain-relief medication and the omission of nasogastric and drainage tubes in certain selected patients. The role of patient education and full physician–patient cooperation.
The pathophysiology of pain and postoperative ileus has been discussed in the paper, and contemporary views on the prevention of these undesirable effects of surgical intervention have been presented, including new drugs currently under clinical tests.
„Fast track” surgery yields substantial financial benefits, which, considering the current state of Polish healthcare, is of the utmost importance.