*Experimental strategies
Preoperative
- Reduction of Psychological Stress & Anxiety:
- Patient information
- Premedication with anxiolytics
- Optimal preoperative nutrition & hydration
- Carbohydrate loading
- Prevention of prolonged fasting
Perioperative
- Anaesthetic Technique:
- Appropriate doses of anaesthetic drugs & anaesthetic depth
- Regional & local anaesthetic blocks
- Opioid-sparing (multi-modal) analgesia
- Use of etomidate
- Surgical Technique:
- Minimally invasive surgical techniques
- Fluid & Temperature management:
- Avoidance of hypothermia
- Avoidance of excess fluid administration
- Catecholamine suppressing drugs:
- A2 agonists
- B blockers
- Hormonal modifiers:
- Glucocorticoids
- Anabolic agents (e.g. Growth hormone)
Postoperative
- Pain management:
- Minimisation of pain
- Opioid-sparing (multi-modal) analgesia
- Nutritional support:
- Early oral nutrition
- Adequate dietary protein
- Glycaemic control
- Immunonutrition
- Probiotics
- Environment & Interaction:
- Early mobilisation
- Exercise
- Avoidance of sleep disturbance